Introduction

The subject of pediatric PICCs encompasses ages from neonate to the young adult of 18 or older. With this broad range of ages, it is necessary to focus first on general aspects of PICC placement and then on specific ages as applied to PICCs, their applications and usage. Many aspects of PICCs covered in this course also apply to adult PICCs, especially in dealing with pediatric patients over the age of 12. Variations are seen more in the younger age groups with smaller catheters, use of play therapy and sedation for movement control. For all ages of pediatric patients and PICCs, efforts are made to provide examples, growth and development pointers and tips for increasing your success in achieving the best outcome for your patients.

About the Authors
Nancy Moureau, BSN, CRNI
Nancy Moureau is an internationally recognized speaker on peripherally inserted central catheters and issues of intravenous practice. She received her PICC insertion training at MD Anderson Cancer center in Houston, Texas. Nancy has been a member of INS since 1985, received her CRNI in 1987, and currently practices at Greenville Memorial Hospital. Nancy’s current work includes management of PICC Excellence, Inc., an educational company specializing in PICC, midline and intravenous training programs. Nancy actively consults with manufacturers, distributors, home health companies, infusion pharmacies, attorneys and hospitals on PICC lines and other issues dealing with intravenous therapy education. PICC Excellence is a resource for questions and education for all things vascular access. For more information about Nancy Moureau or PICC Excellence, visit us online at www.piccexcellence.com.
Linda Burns, RN
Linda Burns is a pediatric vascular access specialist at Children’s Health Care of Atlanta. She graduated in 1985 and started her own company inserting PICCs in 1993. She has been working at Children’s Health Care of Atlanta since 1996 where she was hired to initiate the pediatric PICC program at that facility. In addition to working at CHOA, Linda also teaches PICC insertion classes monthly in Atlanta for PICC Excellence. Linda is also a member of AVA at the national level.
Darcy Doellman
Darcy Doellman is the team leader for the PICC resource service at Cincinnati Children's Hospital Medical Center. In 2003 Darcy received the Suzanne LaVere Herbst Award for Excellence in Vascular Access Practice, presented by the National Association of Vascular Access Networks. She was honored for "making a substantial contribution to vascular access practice by improving patient outcomes" and "contributing to the science of vascular access." Cincinnati Children's Hospital Medical Center is a national model for PICC-line placement.

Upon completion of this program, you will be able to:

• Define peripherally inserted central catheter by acknowledging the Infusion Nurses Standards of Practice designation for terminal tip location for children and neonates
• State the pediatric/neonatal indications for PICC versus midline placement
• List three benefits associated with the use of peripherally inserted central catheters
• Describe three main veins and three alternate veins utilized for insertion of catheters with children and neonates
• Review major anatomical features of the pediatric vascular system
• Differentiate two main insertion methods associated with the use of PICCs
• Explain pediatric/neonatal care and maintenance procedures acceptable for use with PICC and midline catheters including flushing and dressing changes
• Recognize three potential complications associated with the use of PICCs
• Demonstrate the ability to maintain a sterile field during a simulated PICC insertion
• Complete the post-test with a score of 80% or higher demonstrating knowledge of material presented