A peripherally inserted central catheter, a PICC line, is a thin, flexible tube inserted into a vein in the arm, typically above the elbow. This line extends into a large vein near the heart, providing a direct pathway to the central circulatory system. Healthcare providers use PICC lines for various purposes, including long-term administration of medications like chemotherapy, antibiotics, or antifungal treatments, as well as for delivering liquid nutrition when the digestive system cannot process food. While PICC lines offer benefits by avoiding frequent needle sticks and reducing irritation to smaller veins, they also carry a potential risk of infection.
Recognizing Infection Signs
Recognizing the signs of a PICC line infection is important for prompt medical attention. One common indication is localized changes at the insertion site, such as redness, swelling, or warmth to the touch. You might also experience pain or tenderness around the area where the line enters your arm, or even in your armpit.
Pus or unusual drainage from the insertion site, possibly with a foul smell, can also be a sign. Beyond localized symptoms, systemic signs include a fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills. If any of these signs appear, contacting a healthcare provider immediately or seeking emergency care is important.
Understanding Infection Causes
PICC line infections, often called Central Line-Associated Bloodstream Infections (CLABSI), occur when germs enter the bloodstream through the catheter. The most frequent cause is bacteria from the patient’s skin, which can travel along the outside of the catheter into the bloodstream. Contaminated equipment used during the line insertion or subsequent care can also introduce microorganisms.
Improper handling of the PICC line during dressing changes, medication administration, or flushing procedures can also lead to infection. This includes inadequate hand hygiene by the patient or healthcare provider. In some instances, bacteria from other parts of the body can spread through the bloodstream and colonize the PICC line, leading to an infection.
Treatment Approaches
Treatment for a PICC line infection involves eliminating the invading microorganisms. Antibiotics are commonly prescribed, often started empirically based on the suspected type of infection and later adjusted once specific bacteria are identified through blood cultures. These medications can be administered either orally or intravenously, depending on the severity and type of infection.
If the infection is severe, persistent, or involves the catheter, PICC line removal may be necessary. Sometimes, a new PICC line might be placed at a different site after the infection has cleared. Following treatment, follow-up care is required to ensure the infection is resolved and to monitor for recurrence or complications.
Preventing Infection
Preventing PICC line infections involves adherence to specific care practices. Hand hygiene is a primary defense, requiring thorough washing with soap and water or using an alcohol-based hand sanitizer before touching the PICC line or its dressing. Maintaining a sterile environment during dressing changes is also important, often involving sterile gloves and supplies as instructed by healthcare professionals.
Keeping the insertion site clean and dry is another measure; patients should avoid submerging the arm with the PICC line in water, such as during baths or swimming, and use waterproof covers for showering. Regularly check the insertion site for changes and promptly report redness, swelling, pain, or drainage to a healthcare provider for early intervention. Adhering to all specific care instructions provided by your medical team reduces the risk of infection.