Use of peripherally inserted central catheters (PICCs) has grown in popularity as a replacement of other central venous catheters. PICC placements do pose risks and potential complications. Suboptimal catheter insertion and tip position are associated with many of the complications seen with PICC lines. Proper placement and monitoring are important components of minimizing both short- and long-term risks and maximizing the impact of therapy. Chest radiography, fluoroscopy, sonography, electrocardiography guidance, and other imaging techniques can be used to confirm tip location but each technique is associated with important benefits and risks. Although radiographers do not place PICC lines, they are providing image guidance for this procedure, and choosing wisely is an important component of providing optimal care. This article is meant to educate radiographers about imaging options for guiding PICC line placement and to provide a better, broad understanding of this procedure by discussing the appropriate placement of a PICC line, as well as potential complications that may occur when the PICC is improperly positioned. Features for limiting radiation exposure when using fluoroscopy equipment will be described, along with specific advantages and disadvantages associated with various imaging modalities used to guide PICC placement.
After reading this article, the participant should be able to:
- Define the appropriate placement of a peripherally inserted central venous catheter (PICC) line.
- Identify the potential complications associated with improperly positioned PICCs.
- Describe various features of fluoroscopy equipment that limit radiation exposure to patients and personnel.
- Discuss the advantages and disadvantages of various imaging modalities to guide PICC placement.
Categories: Radiation Safety/Protection, Ultrasound/Sonography, X-ray/Radiography