Placement

• A PICC is a long, thin, flexible tube inserted into the patient through a peripheral vein, usually one located in the upper arm. Using ultrasound technology assistance, a certified nurse specialist threads the catheter through the vein until its tip reaches the lower third of the superior vena cava, the major vein responsible for carrying blood back to the heart from the head and upper body.
  
  

Procedure

• Bard Access Systems, a manufacturer of vascular access devices, recommends that before conducting CVP monitoring, a clinician should ensure the catheter is in proper position, flush the catheter with sterile saline and ensure the pressure monitoring assembly located at the external end of the catheter is at the level of the right upper chamber of the heart, or atrium. They claim that maintaining a continuous infusion of saline through the catheter while measuring CVP improves result accuracy.
  
  

Advantages

• PICC insertion carries less risk of complications than other methods commonly used for central venous access yet, according to a study published by the University of Kansas Medical Center in 2010, provides CVP measurements as accurate as those obtained using more invasive techniques.