Table.

Upper Extremity PICC Placements and Effects of Arm Positioning

Upper Arm Position for Optimal PICC Effect of Elbow Effect of
Extremity Insertion of PICC Tip Position Flexion on Tip Shoulder
PICC Type Position Adduction on Tip
Position
Cephalic 90 degree abduction T3-T5 Inward migration Outward
of shoulder (SVC) toward the heart migration, away
(if PICC insertion from the heart
is distal to elbow)

Basilic 90 degree abduction T3-T5 Inward migration Inward migration,

of shoulder (SVC) toward the heart toward the heart
(if PICC insertion
is distal to elbow)
Axillary 120 degree abduction T3-T5 No change in tip Inward migration,
of the shoulder (hand (SVC) location toward the heart
resting by the ear)
PICC, peripherally inserted central catheter; SVC, superior vena cava.

Courtesy of A. Kiefer