Recently we discovered that our CT and MRI contrast osmolarity was anywheres from 616mOsm and 1117 mOsm. According research we looked at, we found that the recommednations were for not using a midline for any osmolarity >600 mOsm in one reference , and then we discovered that in the iNS standards of Practice 2016 in section 26 section II (page S52)under midline catheters that the osmolarity was listed as "do not use for osmolarity > 900 mOsm.
Obviously this has led to some confusion. Which is the correct number for osmolarity levels for midline infusions? Thanks in advance1
The INS Standards changed in 2016. A midline is in a periphearal vein, so the maximum of 900 mOsm per L is the most recent recommendation. Although there are now midline catheters on the market that can tolerate the pressure from your power injector, there are no studies to my knowledge, done on midlines in the radiology dept. Virtually all contrast agents are hypertonic (hyperosmolar) and that is what makes them vesicants.
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