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Image-guided venous access

PICC line insertion

A PICC (peripherally inserted central catheter) is a thin, flexible tube inserted through a vein in the upper arm, with its tip positioned in a large vein close to the heart. It provides reliable access to the bloodstream for treatments needed over weeks or months.

Dr Ryan McConnell performs image-guided PICC line insertion in Sydney for patients referred by their treating medical team.

For doctors & referrers → Contact the practice →
Illustration of a PICC line: a thin catheter inserted in a vein on the inner upper arm under a clear dressing, running through the arm and chest veins to end just above the heart

Reasons for a PICC

Why might I need a PICC line?

A PICC may be recommended when you need intravenous treatment over a period of time, or when repeated cannulas would be difficult or uncomfortable. Common reasons include:

  • intravenous antibiotics, including treatment at home
  • chemotherapy and other cancer treatments
  • intravenous nutrition
  • medications that can irritate smaller veins
  • frequent blood tests or infusions

Your treating team will decide whether a PICC, a Port-a-Cath or another type of venous access is most suitable for your treatment.

Venous access procedures →

The procedure

How is a PICC line inserted?

PICC insertion is performed in a procedure room using ultrasound and X-ray guidance.

  • Ultrasound is used to assess the veins of the upper arm and select a suitable vein.
  • The skin is cleaned and numbed with local anaesthetic.
  • A needle is placed into the vein under ultrasound guidance, and the catheter is advanced through the vein towards the chest.
  • X-ray imaging is used to guide and confirm the final position of the catheter tip.
  • The line is secured at the skin and covered with a sterile dressing.

The procedure usually takes around 30–45 minutes. Most PICCs are inserted as a day procedure, and the line can usually be used straight away once its position has been confirmed.

Suggested image

Ultrasound image of an upper-arm vein being accessed during PICC insertion, or the procedure-room set-up with ultrasound guidance.

Comfort

Will I be awake during PICC line insertion?

Yes — PICC insertion is usually performed with local anaesthetic while you are awake. You may feel pressure or a brief sting during the anaesthetic, but the procedure itself is generally well tolerated. Sedation is rarely needed.

Living with a PICC

Caring for your PICC line

You will receive instructions about caring for your line. In general:

  • the dressing and securement device are changed, and the line flushed, at regular intervals by a nurse — usually weekly
  • keep the dressing clean and dry, and cover it when showering; avoid swimming and baths
  • avoid heavy lifting and vigorous repetitive arm movements on the PICC side
  • blood pressure measurements and blood tests should not be taken from the arm with the PICC unless advised

When to seek medical advice

Contact your treating team or seek urgent medical attention if you notice fever or chills, redness, swelling, pain or discharge at the insertion site, swelling of the arm, hand or neck, leaking or damage to the line, a change in the external length of the catheter, or shortness of breath.

Suggested image

Close-up of a secured PICC line with its clear dressing on the inner upper arm.

Risks & considerations

What are the risks of PICC line insertion?

PICC insertion is a commonly performed procedure, but there are potential risks.

The specific risks for your situation will be discussed before the procedure.

Potential risks include:

  • bruising, bleeding or discomfort at the insertion site
  • infection of the insertion site or bloodstream
  • blood clot (thrombosis) in the arm vein
  • blockage, movement or damage to the catheter
  • difficulty placing the line, which may mean another type of access is needed

After treatment

PICC removal

When treatment is complete, the PICC is removed by gently withdrawing it from the arm. This is usually quick, does not require anaesthetic, and a small dressing is applied afterwards.

FAQs

Frequently asked questions about PICC lines

What is a PICC line?
A PICC is a long, thin catheter inserted through an arm vein so that its tip lies in a large central vein near the heart, allowing medications and fluids to be given and blood samples to be taken.

Where is a PICC line inserted?
Usually through a vein on the inside of the upper arm, just above the elbow, selected using ultrasound.

How long can a PICC line stay in?
A PICC can remain in place for weeks to months, depending on the treatment and how well the line continues to function.

Does PICC insertion hurt?
Local anaesthetic is used to numb the skin. Most people feel only pressure or brief discomfort.

PICC or Port-a-Cath — which is better?
Neither is best for everyone. The choice depends on the treatment, how long access is needed and how often it will be used. See Venous access procedures for a comparison.

Do I need a referral?
PICC lines are generally arranged by your treating specialist or hospital team.

For doctors & referrers

Arrange PICC line insertion

Referring doctors and treating teams can contact the practice to arrange image-guided PICC insertion.

For doctors & referrers → Contact the practice →