I. What is PICC A central venous catheter inserted via the periphery, used to provide medium to long-term intravenous therapy for patients (5 days-1 year). II. Advantages of PICC 1. Reduces the pain of frequent venipuncture and protects the patient’s peripheral veins. 2.High success rate and less complications. 3.It is not easy to dislodge, and the fluid flow rate is not affected by the patient’s body position. 4.Chemotherapy patients avoid extravasation of chemotherapy drugs. 5.The retention time is long, and the catheter can be left in place for up to 1 year. 6, can be inserted by the nurse at the patient’s bedside, without local anesthesia and suture fixation. Indications for PICC 1.Tendency of lacking peripheral venous access; 2.Need to infuse irritating drugs, such as chemotherapy drugs; 3.Need to infuse hypertonic or viscous fluids, such as intravenous hypernutrition; 4.Need long-term intravenous treatment, such as rehydration or pain treatment; 5.The same applies to children (more than 4 years old, children who can cooperate). IV. Contraindications to PICC 1.Peripheral veins cannot be confirmed; 2.Patient’s poor compliance; 3.Pre-insertion route with history of venous thrombosis, source of infection, history of trauma, history of vascular surgery, history of radiation therapy; 4.Severe bleeding disorders; 5.Superior vena cava compression syndrome. 6. Vascular malformation. V. Catheter selection – catheters with three valves 1. reduce the risk of blood return and air embolism; 2. no need to use catheter clamps, reducing the chance of catheter damage; 3. only need to flush the catheter every 7 days between treatments, greatly reducing the risk of infection. VI. Precautions 1. Treatment of bleeding (1) The most frequent complication after puncture; (2) Immediate compression of the puncture site (i.e., the location covered by gauze or cotton balls) for 10-15 minutes; (3) Please minimize the flexion of your elbow for 3 days. (2) Treatment of hand swelling (1) Flexion and extension movements of the palm of the hand, i.e., make a fist –> release a fist –> make a fist several times in a row. (2) Hold a hot towel in the hand to promote blood reflux, pay attention to the water temperature to prevent burns. (3) Compress the puncture point and elevate the arm where the tube is placed. 3. Time for changing the film, flushing the tube and needle-free connector (1) The film must be changed once from 24 hours to 72 hours after the tube placement. (2) Flush the tube, replace the film and connector once a week if there is no abnormality at the puncture site. Prevention and treatment of phlebitis (1) Apply ointment after daily hot compress as prescribed by the doctor 3 times a day for 10 days. (2) If you have any discomfort at the placement site, tell the nurse in time, and the nurse will deal with it according to the situation. 5.High-pressure injection is strictly forbidden: the enhanced drug administration required during CT and MRI examinations may easily cause catheter rupture. 6.Suspected contamination, sweating, rolled edges of the film and other special circumstances, should be replaced at any time. 7.Do not lift heavy objects and do not exercise vigorously with the catheterized arm, but move freely. 8.Patients should carry the PICC catheter with them every time they change the film.