How is a PICC line placed?

1. A vein in the upper extremity is punctured.
2. A guidewire is inserted in the vein and followed centrally under fluoroscopic guidance. (The guidewire will follow a linear course without resistance when introduced into the lumen of a vessel.)
3. The needle is removed.
4. The introducer sheath is advanced over the guidewire, and the guidewire is removed, leaving the introducer sheath behind.
5. The catheter is advanced until the tip lies in the SVC adjacent to the right atrium, and the sheath is removed.
6. The catheter is sutured in place with nonresorbable suture.
7. A semipermeable transparent dressing is placed over the site.
8. A CXR is taken to document tip position.