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PICC Placement: Challenges and Safety Issues to Consider for Sonography and X-ray

Linda Giering, PhD

*Medical Writer, Matawan, New Jersey.
Address correspondence to: Linda Giering, PhD. E-mail: lindagiering@gmail.com.

Disclosures: The author reports having no significant financial or advisory relationships with corporate organizations related to this activity.

ABSTRACT

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.

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