Bedside peripherally inserted central catheter placement: focus on the procedure

A peripherally inserted central catheter (PICC) provides long-term central venous access through a peripheral vein in an upper extremity. A trained physician should insert a PICC, but any trained medical professional, such as a specially trained nurse, can perform an insertion. Appropriate PICC placement reduces complications, such as malposition and malfunction of the catheter, venous thrombosis, and infections, and overall catheter performance is better. Complications depend mainly on the adequacy of venous puncture or the positioning of the catheter tip. Better PICC performance depends on learning accurate techniques for insertion. Here, the overall procedure for bedside ultrasonography-guided PICC placement, including patient positioning, catheter preparation, venous assessment and measurement, overall technique, and catheter tip positioning, is described.