PICC Line Course

Lesson 1 • Central Venous Anatomy Review

Traces the superior vena cava, cavoatrial junction, and right atrium. Defines the target tip position and explains haemodynamic significance of correct placement.

Lesson 2 • Principles of Intravenous Therapy

Reviews osmolarity, pH, and flow-rate concepts relevant to central line therapy. Connects infusion science to catheter selection and tip positioning decisions.

Lesson 3 • Upper Extremity Venous Anatomy

Covers basilic, cephalic, and brachial veins with depth and diameter data. Provides the anatomical map required for safe PICC insertion site selection.

Lesson 1 • Infection Prevention Principles

Applies maximal sterile barrier technique and bundle-based care to PICC insertion. Directly reduces central line-associated bloodstream infection risk.

Lesson 2 • Risk Assessment and Patient Screening

Applies structured tools to identify coagulopathy, allergy, and anatomical risk factors before insertion. Reduces preventable complications through systematic pre-procedure evaluation.

Lesson 3 • Governing Guidelines and Standards

Surveys professional society recommendations and accreditation expectations for PICC practice. Establishes the regulatory framework that shapes every procedural decision.

Lesson 1 • Adjunct Supplies and Securement Devices

Reviews dressings, securement devices, and needleless connectors used throughout the PICC lifecycle. Connects supply selection to infection prevention and catheter longevity.

Lesson 2 • Ultrasound Guidance Fundamentals

Introduces B-mode ultrasound physics, probe selection, and image optimisation for vein visualisation. Builds the scanning skills prerequisite to safe needle guidance.

Lesson 3 • ECG-Based Tip Confirmation Technology

Explains intracavitary ECG waveform changes used to confirm tip position at the cavoatrial junction. Reduces reliance on post-insertion chest X-ray for tip verification.

Lesson 4 • Insertion Kit Assembly and Sterile Setup

Walks through tray contents, sterile field creation, and pre-flush preparation in correct sequence. Prevents contamination errors before the procedure begins.

Lesson 1 • Short-Axis Out-of-Plane Technique

Teaches transverse probe orientation with needle tip tracking through sequential image slices. Provides rapid vessel access with a compact footprint in the antecubital fossa.

Lesson 2 • Difficult Access Strategies

Addresses small, deep, or thrombosed veins with modified techniques and alternative site selection. Prepares learners to manage challenging anatomy without escalating to higher-risk access.

Lesson 3 • Long-Axis In-Plane Technique

Demonstrates longitudinal probe alignment for continuous needle visualisation from skin to vessel lumen. Improves confidence in deep vessel cannulation and reduces arterial puncture risk.

Lesson 4 • Probe Handling and Ergonomics

Establishes correct probe grip, patient arm positioning, and operator stance for controlled scanning. Reduces hand fatigue and probe drift during needle advancement.

Lesson 1 • Pre-Procedure Patient Preparation

Covers patient identification, positioning, arm measurement, and time-out completion before incision. Ensures procedural safety checks are embedded as non-negotiable first steps.

Lesson 2 • Catheter Advancement and Tip Positioning

Advances the trimmed catheter through the sheath to the cavoatrial junction using ECG or fluoroscopic guidance. Achieves confirmed optimal tip position before sheath removal.

Lesson 3 • Introducer Placement and Tract Dilation

Guides nick incision, dilator passage, and peel-away introducer sheath placement over the guidewire. Creates the conduit through which the catheter is advanced into the vein.

Lesson 4 • Sheath Removal and Catheter Securement

Peels and removes the introducer sheath without disturbing catheter position, then applies securement and dressing. Finalises the insertion and protects catheter integrity at the exit site.

Lesson 1 • Chest X-Ray Interpretation for PICC

Teaches systematic radiograph review to locate catheter tip relative to carina and vertebral landmarks. Enables independent tip position assessment without specialist radiology support.

Lesson 2 • Recognising Malposition Patterns

Identifies common malpositions including internal jugular, axillary, and right atrial tip locations on imaging. Prepares learners to detect and report malposition before initiating therapy.

Lesson 3 • Malposition Correction Techniques

Applies repositioning manoeuvres including arm position change, catheter withdrawal, and fluoroscopic redirection. Restores optimal tip position without full catheter removal when possible.

Lesson 4 • Alternative Confirmation Technologies

Compares fluoroscopy, intracavitary ECG, and magnetic navigation as confirmation modalities. Guides selection of the most appropriate technology for each clinical setting.

Lesson 1 • Catheter Removal Procedure

Describes the indications, technique, and post-removal assessment for planned and urgent PICC removal. Ensures safe, complete catheter extraction with tip integrity verification.

Lesson 2 • Patient and Caregiver Education

Prepares patients and home caregivers to recognise complications, protect the catheter, and perform basic maintenance tasks. Extends safe PICC care beyond the clinical setting.

Lesson 3 • Dressing Change Protocol

Executes sterile dressing changes at required intervals using correct removal and reapplication technique. Maintains exit-site integrity and reduces infection risk over the catheter dwell period.

Lesson 4 • Needleless Connector Management

Covers connector disinfection, change frequency, and correct clamping sequence to prevent reflux and contamination. Directly impacts catheter-related bloodstream infection and occlusion rates.

Lesson 1 • Vascular and Cardiac Complications

Identifies arterial puncture, haemothorax, cardiac arrhythmia, and cardiac tamponade as rare but critical events. Equips learners with immediate response protocols for each life-threatening scenario.

Lesson 2 • Mechanical Complications

Addresses catheter fracture, migration, pinch-off syndrome, and accidental dislodgement with corrective actions. Prevents life-threatening embolism through early recognition and structured response.

Lesson 3 • Upper Extremity Deep Vein Thrombosis

Covers risk factors, clinical signs, ultrasound diagnosis, and anticoagulation management of PICC-related DVT. Prepares learners to detect thrombosis early and coordinate treatment decisions.

Lesson 4 • Catheter-Related Bloodstream Infection

Defines diagnostic criteria, risk factors, and treatment pathways for PICC-associated bloodstream infection. Connects prevention bundle adherence to measurable infection rate reduction.