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Peripherally Inserted Central Venous Catheters: A Comprehensive Guide

Vincent Mitchell

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Peripherally inserted central venous catheters (PICCs) are a type of intravenous catheter that is placed in a vein in the arm and threaded into a large vein in the chest. PICCs are used to deliver medications, fluids, and blood products, and can remain in place for weeks or months.

Peripherally Inserted Central Venous Catheters

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PICCs are often used in patients who need long-term intravenous therapy, such as those with cancer, HIV/AIDS, or other chronic illnesses. PICCs can also be used in patients who need short-term intravenous therapy, such as those who are recovering from surgery or who are receiving antibiotics.

Indications for PICC Placement

PICCs are indicated for a variety of reasons, including:

* Long-term intravenous therapy * Short-term intravenous therapy * Administration of medications that are irritating to veins * Administration of medications that require a high flow rate * Monitoring of central venous pressure * Blood sampling

Contraindications to PICC Placement

PICCs are not recommended for patients with the following conditions:

* Active infection at the insertion site * Thrombosis of the vein in which the PICC is to be placed * Severe coagulopathy * Severe thrombocytopenia * History of PICC-related complications

Insertion Techniques

PICCs are inserted using a variety of techniques, including:

* Seldinger technique * Modified Seldinger technique * Ultrasound-guided insertion

The Seldinger technique is the most common method of PICC insertion. In this technique, a small needle is inserted into the vein and a guidewire is threaded through the needle. The needle is then removed and a dilator is inserted over the guidewire. The dilator is then removed and the PICC is inserted over the guidewire.

The modified Seldinger technique is similar to the Seldinger technique, except that a small incision is made in the skin before the needle is inserted. This technique is often used in patients with difficult veins.

Ultrasound-guided insertion is a technique that uses ultrasound to visualize the vein and guide the insertion of the PICC. This technique is often used in patients with difficult veins or in patients who have had previous PICC-related complications.