Services

Nebraska PICC Specialists, LLC provides 24/7 vascular access services, as well as the following services.

Please call for more specific information and how we can assist your facility.

PICC

A peripherally inserted central catheter (PICC) is a long, thin catheter placed in the upper arm and threaded into a large vein above the heart. The tip is in the distal superior vena cava (SVC) or optimally at the cavo atrial junction (CAJ).

A PICC line gives your medical team access to the large, central vein in the chest for medications that can be inappropriate for peripheral intravenous catheters (PIVs), such as vesicant medication, total parental nutrition (TPN), multiple infusions, poor peripheral venous access, chemotherapy, invasive hemodynamic monitoring, numerous blood draws, and long-term infusion therapy.

PICCs are placed by highly skilled professionals such as radiologists, physician assistants, nurse practitioners, and registered nurses trained in ultrasound-guided PICC placement. Difficult PICC insertions may be performed in a Radiology suite.

A PICC line requires careful monitoring, care, and maintenance to prevent a central line-associated bloodstream infection (CLABSI). Dressing changes are performed weekly or if the dressing becomes soiled or wet.

The following are PICC line complications, which will be discussed with you before the PICC placement. Written consent is required before the placement of a PICC.

Deep Vein Thrombosis (DVT)
Nerve Injury
Irregular heartbeat
Phlebitis
Catheter malposition
Inadvertent arterial stick
Air emboli
Occlusion

Midline

A midline catheter is a thin catheter placed in the upper arm veins with the tip at the axilla's level.

Midline catheters are often placed when lower extremity veins are poor, and the patient receives medicine compatible with peripheral IV (PIV) therapy. Continued vesicant medications are not suitable for PIV therapy.

Midlines are placed by skilled professionals trained in ultrasound-guided midline placement.

The following are Midline complications, which are discussed with you before the Midline placement. Written consent is not required unless the facility requires it.

Deep Vein Thrombosis (DVT)
Nerve Injury
Phlebitis
Catheter malposition
Infiltration of infusion or extravasation
Potential arterial stick
Occlusion

Ultrasound-guided PIV Placement

Ultrasound-guided PIV are placed with visualization of the veins in the lower extremity are not achievable.

Ultrasound guidance increases first-attempt success, number of insertion attempts, and lower fail rate compared to palpation.

Ultrasound-guided PIVs are placed by skilled clinicians trained in ultrasound-guided insertions.

Complications with ultrasound-guided PIV placement include:

Infiltration of infusion or extravasation
Nerve Injury
Potential artery stick
Phlebitis
Occlusion

Care & Maintenance

Care and Maintenance of all vascular access is performed by clinicians trained in care and maintenance of all vascular access catheters based on facility policy and procedures.

Included cares:

Central Line dressing changes
Midline dressing changes
PIV dressing changes
Treating occluded central lines