IV therapy at home/PICC question

[ToriMom]

Our daughter is supposed to start IV therapy at home, but we have always done them inpatient for a few days (or weeks) first. My question is...when you go in to get your PICC lines do the interventional radiologists put you to sleep first? When they say "sedation" do they mean Versed or something where you are still awake? Is it a day surgery admission or what? We had a PICC placed once with minimal sedation (she was wide awake) and it was very traumatic for her.

Thanks for any feedback,
Michelle, mom to Victoria-- CF, g-tube, age 11

 

[running4life]

I'm 25 and my first and only PICC line was placed without any sedation earlier this year. They said they would give me Ativan, but they didn't and I didn't care to wait until it kicked in. I was ready to start my meds. I've heard with a lot of kids, they put them to sleep for an outpatient procedure.

 

[bethylove]

Hi ToriMom,

I had my first picc placed when I was a kid, and while they tried to do it without anything, I ended up having this massive panic attack and basically it was pure chaos. After that I got a dandy little note in my chart saying I needed 'conscious sedation' in order for a picc to be placed.

When doing CS during a picc placement you go to IR because they have all the necessary equipment (monitors and whatnot). I get a mix of versed and some pain management/blocker - this one varies, but the versed is usually a concrete.

When I get rolled into the room (I've usually already been giving a dose of Ativan at this point since I get really freaked out by the whole ordeal) and then they hook me up all the monitors: blood pressure, heart monitors pulsox, etc etc and then the nurse usually chats with me as she pushes a few cc's at a time of versed & pain blocker. Next think I know, I'm waking up in my room and I have a picc in my arm. Sometimes they come in to ultrasound my arm first before or during the hooking up to monitors process.

Then I sleep for the rest of the day.

While, I think, technically you're "awake" during the procedure, you're so loopy you don't care, and then versed has a nifty side effect of making you forget as it wears off.

It's a much easier process for me mentally than getting one placed bedside. It's not the pain that gets me, they're pretty painless once you get the numbing shot, it's all mental.

I hope things go well for you and your daughter! Good luck.

 

[lilmac7]

I had a PICC placed just last Monday and no sedation whatsoever, just some injections to numb the area on my arm. I'm 30 yrs old though so it might be different for kids. I will say there was allot of blood and the procedure took longer than expected cause the dang thing was giving trouble going in the vein, the piece that is put in then the tube fed in through it. I'm not squirmish to blood so it was no biggie but there was quite a bit when it was said and done. The Doc that placed it even joked when he was finished that I was really good to deal with, I didn't move and react like many of his other patients - then he said "apart from you probably needing a blood transfusion now". I didn't feel anything other than a few little pricks with the numbing injections and all the pressure he placed when fighting to get the thing in and control the bleeding. So with that said I probably would opt for some kind of sedation for a child.

 

[MichaelL]

I've had PICC lines placed for home treatments. They've always numbed my arm but not put me out. In my case, it's generally done by an x-ray technician in the x-ray department and takes 45 minutes or so.

I had one bad experience with a resident who didn't know what he was doing. I was told later that CF veins are tricky to work with so it's best to get someone experienced.

I'm 45 and I find it stressful to get a new PICC. Good luck -- I hope it goes well for you daughter.

 

[Jennyvb17]

I just had a line placed as well, I am always awake. It's no big deal, just turn my head so I don't see. The person placing it always chats to you the whole time. When I was younger, 14 when I had my first, they would put me under the whole way. The hard part about that is it takes going without food and real sedation is always a risk.
I have also had a topical anesthesia used to make the numbing shots not so bad

 

[CrisDopher]

I just want to say: thank god for Lidocaine!! I've never been sedated for any of my lines, until my port was put in.

 

[Badger]

to answer the question, Ive always been awake for all my picc lines. I now have a port which I prefer. The picc lines were giving me blood clots.

 

[NoelA]

My daughter was sedated for ALL of hers. I thought it was a little weird because in one of my classes we talked about PICC insertion at the bedside (using sterile technique. of course!) and I was shocked! I had no idea that it could be done while the pt was awake. My daughter was 5 when she had her first PICC insertion. The others have been done simultaneously during a bronchoscopy or sinus surgery, so she had to be sedated, anyway. They don't like giving ANYONE with respiratory problems pain med's (in the opioid family) or anesthesia unless they HAVE to because they cause respiratory depression. I would hope, with her not doing well with it the first time, that they would give her something to alleviate her anxieties. Ask them about it and let them know why you are concerned (negative past experiences).

 

[joseph_humphreys]

It is advisable to perform it in the hospital or clinic because PICC inserted by radiologists, physician assistants or certified registered nurses. They are inserted using ultrasound technology at the bedside or ultrasound with fluoroscopy.

 

[Tisha]

We don't do PICC lines in Spain at all, they are considered risky for infections. We do peripherical while you can, but I'd say get a port as soon as possible! They are so convenient!

 

[Daverog75]

Hello,

I have had over a dozen PICC lines and was never sedated but I am in my 30's. I can sure understand how this would be hard for a child to go through this procedure. I think maybe you should ask them to sedate her.

Dave 37 w/cf and currently on the transplant list.