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blood culture + and mid line insertion

  It is certain that picc line is inserted afer blood culture becomes negative.

  What about midline?


  Team requires often midline for difficult vein and pt still has positive blood culture.

  Even thoug midline is considered peripheral, due to the long dwell , I would like to educate our team with certain rules based on evidence.

 And Some ( physicians) believe that putting midline is okay after some certain doses of antibiotics ( like 3-4 doses?).

  Do we have any published, and agreed rule about midline insertion with positive blood culture ?

There are no standards or

There are no standards or guidelines addressing this question. And I have found very little published evidence or studies to answer this. Waiting for negative blood cultures for any CVAD insertion is NOT included in any document on CLABSI prevention. At present, this is based on the opinions of the LIP and it would be the same for a midline or a PIV. Any piece of plastic could become colonized but the question is DO they become colonized. IMHO, I firmly believe you should immediately insert the VAD that is best for the patient after a complete assessment of all patient, therapy, venue and VAD factors. 

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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