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Central Venous Access And PICC Line Services

Central Venous Access And PICC Line Services in Bhubaneshwar

The Central Venous Access (CVAD) device aims to focus on administering certain medications, such as chemotherapy drugs, blood transfusions, and nutrients, and also aids in extracting blood samples. They include central venous catheters (CVCs), umbilical vein catheters (UVCs), umbilical artery catheters (UACs), and peripherally inserted central catheters (PICCs). CVADs are generally inserted with the help of guided scans, such as ultrasonography (US), into the jugular, subclavian, and femoral veins, while a peripherally inserted central catheter (PICC) line is inserted into the peripheral vein.

Peripherally Inserted Central Catheter (PICC) Line

A PICC line categorised as a CVAD shares similar objectives with other devices of its kind. It is usually performed by radiologists or skilled nurses who use imaging such as X-rays or ultrasounds to guide the insertion of the catheter. Tubes in PICC lines are generally made of plastic or silicone and are inserted into the peripheral vein, extending to the superior vena cava near the heart.

Our medical professionals at Manipal Hospitals are proficient in employing advanced techniques in the insertion and administration procedures, ensuring and prioritising patient safety and comfort throughout the process.

FAQ's

Your child might need a CVAD if medications need to be administered, periodically or continuously, for more than 2 weeks, thereby bypassing the need for multiple needles for administration. The duration for a CVAD to stay in place depends on factors such as the treatment of the child and the type of device used, with time generally spanning several months to a year. CVAD insertion sites are assessed thoroughly by your specialist to rule out any complications or risks that may arise during administration.

CVAD and PICC line insertion is done by skilled radiologists or nurses with the help of imaging-guided scans, which include X-ray and USG scans. They can occur either as an outpatient or inpatient procedure and are generally done in an operating room or at the bedside. During the procedure, your child will be numbed with anaesthetics to reduce pain around the site, although they may feel mild discomfort when the catheter is passed through the veins.

Possible risks or complications that may arise due to the insertion of CVAD and PICC include:

  • Infections: Because the insertions take place in hospitals, paediatric patients are prone to hospital-acquired catheter-related bloodstream infections (CRBSIs), such as Staphylococcus aureus, Candida, Staphylococci, and Enterococci.

  • Catheter Displacement: Incorrectly positioned catheters are detected using X-rays or contrast dye studies and are caused by factors such as abnormalities in the vascular system, patient movement during insertion, venous pressure change within the chest, vigorous physical activity, or rapid fluid flushing.

  • Catheter Malfunction: Reasons for catheter malfunction could be catheter movement during positioning and fractures within the catheter.

  • Blood Clots: Include the formation of thrombosis in the vein, identified by swelling around the site, tightness in the chest, and difficulty breathing.

  • Air Embolism: Reasons contribute to failure to maintain a closed system between the catheter and blood vessels. Regularly examining the clamp, if present in the catheter, could help minimise the risk.

During your initial consultations with your child’s specialist, a blood test will be conducted to assess your child’s blood level. You may also be instructed to stop certain drugs before the procedure. Moreover, ensure that medications prescribed by your child's specialist are followed properly. You might also be advised to restrict your child from eating or drinking for several hours before the procedure if anaesthesia is planned.

Your child’s medical healthcare provider inserts the PICC line with the following steps:

  • The specialist will clean and insert an IV line to sedate the child during the procedure.

  • Imaging-guided scans are employed to determine the appropriate vein for insertion. Anaesthesia is administered at the insertion site to numb the pain.

  • With the help of imaging scans and the insertion of the guide wire, the catheter is passed through the vein. The position of the catheter tip is checked using an X-ray or US.

Your child’s medical healthcare provider will provide you with personalised instructions on caring for your child’s PICC line at home. General instructions, however, include the following:

  • Coming for weekly catheter flushing scheduled by your child’s doctor

  • Limiting sports that are vigorous and rough and extreme exercises

  • Being cautious when showering or taking a bath with a CVAD or a PICC line

  • Following your child’s medication schedule

  • Getting guidance on changing caps, if present

Seeking immediate medical attention for your child if risks such as infections, swelling, or blockage of the catheter are manifested.  

Your child can take a bath or shower with a PICC line after 24–48 hours post-insertion of the catheter. However, it is important not to wet the PICC line or the dressing over it to prevent infection. Your child’s specialist will instruct you to cover your child’s PICC line insertion site or may cover it with a waterproof bandage.

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