By looking at the old standards of practice it looks like a midline falls under the peripheral iv insertion section, which does not include maximum barrier precautions. On the INS sample policy book it
makes mention of full maximum barrier precautions. The kits that come from company, we will be using Bard Power Glide, when full kits.......include a medium sterile fenestrated drape, not full body drape and then skin prep and insertion supplies only. NO sterile gown, full drape etc.....
Typically I would go by the INS standards which seems to state and categorize it under a peripheral and the same precautions using the No Touch technique.
What is the consensus on this?
thanks, Gina Ward R.N., VA-BC
A midline catheter resides in a peripheral vein and is therefore grouped with the short peripheral catherers in some standards. The new standard is to "Consider the use of maximal sterile barrier precautions with midline catheter insertion." This is based on 3 studies, 2 of which used the newer midlines. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you so much for your input Lynn
Gina Ward R.N., VA-BC
I have inserted the "classic" midline catheter using modified seldinger technique with threading a wire into the vessel. I have also inserted the Bard PowerGlide with all in one contained unit and a smaller barrier and a mask. I have never considered the "no-touch" technique to insert them like short peripheral lines since that implies non sterile gloves to me.
I do agree they are considered peripheral lines, but with the intended extended dwell up to 4 weeks, I believe in a quasi sterile procedure. With the classic midlines and the wire I feel like there is more chance that I would contaminate the wire without a larger barrier. I do feel differently with the all in one unit since I don't have a wire flopping around.
Just my thoughts and feelings.
However, there are some facilities that are using sterile gloves to start short peripheral lines now. They come packaged in the start kits from some suppliers.
Juline DiSilvestro BSN, RN, CRNI, VA-BC, CPUI
Central Access Team Nurse
Inspira Medical Center- Woodbury,NJ
We still use max barrier. Since our Midlines are the identical insertion as out PICC's just cut shorter, we kept everything uniform regarding insertion.
Jack