The arm (from the elbow to the axillary cavity) can be divided into three bands of similar size, corresponding to the proximal third (yellow area of Dawson), the middle third (Dawson's green zone) and the distal third (Dawson's red zone).
We recommend to locate the exit site of the PICC in Dawson's green zone (both in terms of stability and in terms of risk of bacterial contamination) more appropriate. If in the green zone there is no adequate vein in terms of caliber and depth, it is possible, however, to puncture and cannulate a vein of the yellow zone (probably with a larger diameter since it is more proximal) and tunnel the catheter until it exits the green zone .
In the child, where the caliber of the veins is on average smaller than in the adult, the occurrence of having to puncture in the yellow zone (and therefore tunneling) is more frequent than in the adult patient.