Purpose or Case Report: To familiarize the audience with our institution’s technique utilizing ultrasound (US) and electrocardiogram (ECG) for anatomic localization and technical guidance for PICC placement in a pediatric intensive care unit (PICU) procedure suite utilizing intravenous (IV) sedation without general anesthesia to eliminate patient and operator radiation exposure and decrease sedation specifically in a pediatric population.
Methods & Materials: A majority of our institutions pediatric (newborn to 18 years) PICC placements are performed in our PICU procedure suite under IV sedation only, administered by qualified attending pediatric intensivists. The procedure is performed with US and ECG guidance which is described.
Results: Initial procedural suite preparation is described including patient and operator positioning. Patient preparation and localizing ECG device placement as well as ECG interpretation for final PICC placement is explained. Finally, troubleshooting techniques and complication management is reviewed.
Conclusions: Although ECG-guided PICC placement is currently used in the adult population, it is a newer and unique technique used for the pediatric population at our institution allowing decreased sedation times and anesthetic use as well as eliminating patient and operator radiation exposure. The technique is described to the audience.