Peripherally inserted central venous catheters (PICC) are an integral part of oncology care and treatment. There are various techniques of PICC insertion. First being the conventional technique or landmark method in which the most prominent vein usually in anticubital fossa is palpated and canulated with a wide bore needle/ sheath and then the catheter is inserted through the sheath. The other method is ultrasound guided method using micro-introducer needle. This is a newer technique in which the vein, usually basilic vein, in arm, above elbow, is identified under ultrasound and a fine needle of 21 gauge is inserted into vein under direct ultrasound image. After successful puncture of vein, a guide wire is passed through the needle and then the sheath over the guide wire and finally the catheter through the sheath. This is a novel technique with almost 100% success rate and with minimal injury to skin, subcutaneous tissue and vascular wall.
The most important aspect of PICC line care is having a dedicated team of nurses who are trained in PICC insertion, care and maintenance to avoid post insertion complications and infections.
We at Rajiv Gandhi cancer institute and research centre have been using this novel technique of PICC line placement. We have a dedicated team of nurses who take care of PICC insertion, care and maintenance/ dressing and record keeping. This way we have 100% success rate of PICC insertion and a very good outcome in terms of very low catheter related problems.
We are a training center for PICC and already have conducted several sessions of PICC training for doctors and nurses. Usual course frequency is once every month and the duration of course is one week. Salient features of the training program are professionally prepared lectures by a faculty actively involved in PICC care and teaching too. The faculty includes doctors from department of hematology and microbiology as well as our PICC trained qualified nurses.
First PICC training was conducted in July 2014. Till now we have conducted 20 training sessions for 65 candidates including doctors and nurses from different parts of India and also neighboring countries.
Our training program includes teaching modules, hands-on practice of PICC insertion, trouble shooting and care and maintenance as well as record keeping and infection control measures .At end we certify the candidates after formal test.