{"id":53483,"date":"2026-07-08T09:52:00","date_gmt":"2026-07-08T08:52:00","guid":{"rendered":"https:\/\/campusvygon.com\/uk\/?p=53483"},"modified":"2026-06-30T09:54:00","modified_gmt":"2026-06-30T08:54:00","slug":"article-3-picc-devices-explained-selection-and-patient-assessment","status":"publish","type":"post","link":"https:\/\/campusvygon.com\/uk\/vascular-access\/fundamentals-of-picc-practice\/article-3-picc-devices-explained-selection-and-patient-assessment\/","title":{"rendered":"Article 3: PICC Devices Explained: Selection and Patient Assessment"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Selecting the appropriate vascular access device is a critical component of delivering safe, effective and patient-centered care. Peripherally Inserted Central Catheters (PICCs) are widely used across healthcare settings and provide a reliable solution for patients requiring mid to long term intravenous therapy. This article combines key principles of device selection and patient assessment to support informed clinical decision-making.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Overview of PICC devices<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">PICC lines first gained popularity in the 1970s and 1980s and have continued to evolve as a cornerstone of vascular access practice. Typically constructed from silicone or polyurethane, PICCs measure approximately 50 to 60 cm in length and are inserted via veins in the upper arm, most commonly the basilic, cephalic or brachial vein.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The catheter tip is ideally positioned in the lower superior vena cava (SVC) or proximal right atrium. The basilic vein is generally the preferred choice due to its larger diameter, higher blood flow and straighter route to the central circulation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">PICCs are particularly suited to patients requiring mid to long term therapy and can remain in place for the duration of treatment. They are especially appropriate when prescribed infusates are not suitable for peripheral administration.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Factors influencing device selection<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Device selection must be guided by a combination of therapy requirements, patient factors and clinical context.<br><br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Therapy type and duration<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The anticipated dwell time is a key consideration. PICCs are ideal for therapies expected to last several weeks or longer. The characteristics of the infusion are equally important, particularly when dealing with:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Vesicant medications<\/li>\n\n\n\n<li>Irritant drugs<\/li>\n\n\n\n<li>Solutions with extreme pH<\/li>\n\n\n\n<li>Hyperosmolar infusions such as total parenteral nutrition<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">These therapies require delivery into a central vein to minimise the risk of vessel irritation and damage.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Device Characteristics<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Different PICCs offer varying features to support specific clinical needs. For example:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Lifecath PICC: A radiopaque polyurethane catheter suitable for fluids, antibiotics, chemotherapy and analgesia<\/li>\n\n\n\n<li>MaxFlo Expert PICC: Incorporates antimicrobial technology and supports high-pressure injections for contrast delivery<\/li>\n\n\n\n<li>Lifecath PICC Easy: Allows the catheter to be trimmed to the required length following insertion<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Selection should align device functionality with the clinical goals of treatment.<br><br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Local Availability and Expertise<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Device choice may also depend on the availability of equipment within the organisation and the presence of trained staff to insert and maintain the device. Clinicians must balance best practice with practical considerations while always prioritising patient safety.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Indications for PICC placement<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">PICC lines are indicated in a range of clinical scenarios where reliable central access is required. These include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Total parenteral nutrition<\/li>\n\n\n\n<li>Administration of vesicant or irritant medications<\/li>\n\n\n\n<li>Infusions with extreme pH or osmolarity<\/li>\n\n\n\n<li>Extended intravenous therapy<\/li>\n\n\n\n<li>Frequent blood sampling<\/li>\n\n\n\n<li>Patient preference<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Additionally, therapies that exceed the safe limits of peripheral cannulae or midline devices, such as those with osmolarity greater than 900 Osm\/L, support the use of a PICC.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Contraindications<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">PICC insertion may not be appropriate in all patients. Key contraindications include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Inadequate or unsuitable arm veins<\/li>\n\n\n\n<li>Previous mastectomy with lymph node clearance on the intended side, due to the risk of lymphoedema<\/li>\n\n\n\n<li>Presence of an arteriovenous fistula<\/li>\n\n\n\n<li>Difficulty identifying a suitable vein, even with ultrasound guidance<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">In such cases, alternative forms of vascular access should be explored.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Patient Assessment Prior to Insertion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A comprehensive assessment is essential before selecting and inserting a PICC. This ensures the chosen device is suitable, safe and aligned with the patient\u2019s needs.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Clinical Assessment<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The clinician should review:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patient diagnosis and treatment plan<\/li>\n\n\n\n<li>Type and expected duration of therapy<\/li>\n\n\n\n<li>History of infection or sepsis<\/li>\n\n\n\n<li>Use of anticoagulants<\/li>\n\n\n\n<li>Potential need for future renal dialysis<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Investigations such as a full blood count and clotting screen may be required to support safe decision-making.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Vascular assessment<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Assessment of the vascular system should include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Examination of both upper limbs<\/li>\n\n\n\n<li>Ultrasound evaluation of vein size, depth and patency<\/li>\n\n\n\n<li>Consideration of catheter to vein ratio<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">This ensures that the selected vein can safely accommodate the device and maintain adequate blood flow.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Patient history<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A detailed vascular access history should be obtained. Key questions include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Previous vascular access devices and any complications<\/li>\n\n\n\n<li>Ease or difficulty of prior insertions<\/li>\n\n\n\n<li>Location of previous devices<\/li>\n\n\n\n<li>Presence of conditions affecting the arms, such as surgery, stroke or orthopaedic issues<\/li>\n\n\n\n<li>Patient preferences regarding device selection<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Therapy-led decision making<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In some cases, the duration of treatment may be uncertain at the outset. Clinical judgement is required to make an informed decision.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For example, a patient prescribed vancomycin may not yet have a confirmed treatment duration. However, given the drug\u2019s irritant nature and the likelihood of prolonged therapy, a PICC may be the most appropriate option. Consideration of the patient\u2019s overall condition, including comorbidities such as diabetes, further supports this decision.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Effective decision-making involves assessing:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Therapy characteristics<\/li>\n\n\n\n<li>Likely duration<\/li>\n\n\n\n<li>Patient risk factors<\/li>\n\n\n\n<li>Vascular access options<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Considerations for ongoing and community care<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">When a PICC is required for outpatient therapy, additional planning is necessary. Considerations include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Who will be responsible for ongoing care and maintenance<\/li>\n\n\n\n<li>Availability of community nursing support<\/li>\n\n\n\n<li>Competence of staff managing the device<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Ensuring continuity of care is essential to minimise complications and support successful treatment outcomes.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Patient information and consent<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Providing patients with clear, accessible information is a fundamental part of care. This should include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The reason for the PICC<\/li>\n\n\n\n<li>Benefits and limitations<\/li>\n\n\n\n<li>Potential risks<\/li>\n\n\n\n<li>Post-procedure care requirements<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Risks that should be discussed include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Bleeding<\/li>\n\n\n\n<li>Infection<\/li>\n\n\n\n<li>Thrombosis<\/li>\n\n\n\n<li>Tip malposition<\/li>\n\n\n\n<li>Air embolism<\/li>\n\n\n\n<li>Phlebitis<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Patients should be given sufficient time to ask questions and consider their options. Information should be provided both verbally and in writing wherever possible.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Summary<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">PICC device selection is a multifaceted process that requires careful consideration of therapy requirements, patient characteristics and clinical resources. By understanding the indications, recognising contraindications and conducting a thorough patient assessment, clinicians can select the most appropriate device for each individual.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ultimately, safe and effective PICC practice is underpinned by informed decision-making, patient engagement and a commitment to delivering high-quality, evidence-based care.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<div class=\"wp-block-cover alignfull has-white-color has-text-color has-link-color has-small-font-size wp-elements-1b9993e6d29d5374dbbaf8dfa12d7bdd\" style=\"min-height:200px;aspect-ratio:unset;\"><span aria-hidden=\"true\" class=\"wp-block-cover__background has-background-dim-100 has-background-dim\" style=\"background-color:#004431\"><\/span><div class=\"wp-block-cover__inner-container is-layout-flow wp-block-cover-is-layout-flow\">\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile is-vertically-aligned-center is-image-fill-element\" style=\"grid-template-columns:25% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"http:\/\/campusvygon.com\/uk\/wp-content\/uploads\/sites\/9\/2026\/06\/PICC-Series-front-cover-1024x1024.png\" alt=\"\" class=\"wp-image-53543 size-full\" style=\"object-position:50% 50%\" srcset=\"http:\/\/campusvygon.com\/uk\/wp-content\/uploads\/sites\/9\/2026\/06\/PICC-Series-front-cover-1024x1024.png 1024w, http:\/\/campusvygon.com\/uk\/wp-content\/uploads\/sites\/9\/2026\/06\/PICC-Series-front-cover-980x980.png 980w, http:\/\/campusvygon.com\/uk\/wp-content\/uploads\/sites\/9\/2026\/06\/PICC-Series-front-cover-480x480.png 480w\" sizes=\"(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) 1024px, 100vw\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<h2 class=\"wp-block-heading has-text-align-left has-white-color has-text-color\" style=\"font-size:20px\">Infection Prevention in IV Access and Therapy<\/h2>\n\n\n\n<div class=\"wp-block-buttons alignfull is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-outline is-style-outline--1\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/campusvygon.com\/uk\/vascular-access\/fundamentals-of-picc-practice\/article-4-infection-prevention-in-iv-access-and-therapy\/\">Next Article<\/a><\/div>\n<\/div>\n<\/div><\/div>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Selecting the appropriate vascular access device is a critical component of delivering safe, effective and patient-centered care. Peripherally Inserted Central Catheters (PICCs) are widely used across healthcare settings and provide a reliable solution for patients requiring mid to long term intravenous therapy. This article combines key principles of device selection and patient assessment to support [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":53468,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[117],"tags":[47],"class_list":["post-53483","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fundamentals-of-picc-practice","tag-picc-fr"],"acf":[],"_links":{"self":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts\/53483","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/comments?post=53483"}],"version-history":[{"count":5,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts\/53483\/revisions"}],"predecessor-version":[{"id":53595,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts\/53483\/revisions\/53595"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/media\/53468"}],"wp:attachment":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/media?parent=53483"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/categories?post=53483"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/tags?post=53483"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}