STILL TRYING TO GATHER BRAND PREFERENCE DATA FROM THOSE OF YOU WHO USE MIDLINE CATHETERS HOWEVER INFREQUENTLY--What brand do you keep on your shelf and what is the basis of your choice?--Appreciate your opinionsÂ
We don't keep"midline" catheters, but cut Bard Powerpics to midline length when needed. Most of our insertions are central (PICCs). We purchased kits from Bard with all supplies; and all supplies are used in the kit whether midline or central.
We don't keep"midline" catheters, but cut Bard Powerpics to midline length when needed. Most of our insertions are central (PICCs). We purchased kits from Bard with all supplies; and all supplies are used in the kit whether midline or central.
It has been suggested that we do that as well--It seems to me to be not only an off label practice but one that could prove hazardous if used mistakenly as a PICC for administration of irritants or CT contrast power injection--Surely there must be a good 4FR catheter designated as a Midlne that can be inserted using US
You are correct about the off-label use and the dangers of cutting a PICC to be a midline. There are numerous brands of midlines available, but I do not think any of them are labeled for high-pressure injection. High pressure injection at the midline tip location as well as the pressure tolerance of the catheter are the issues. Bard, BD, plus numerous other companies make midline catheters. Lynn
Bard makes the PER Q Cath. It is a silicone catheter. Arrow also has one that is made from polyurethane. They are both 20cm long. You would need to put an MST kit on the field to use ultrasound for insertion. They are very comparable in price. I like the look of the per Q cath--it looks very different and I believe would stand out better--but it is made of silicone. Doesn't chloraprep break down silicone??? I have a question out there about that.
As far as cutting down a power injectable PICC for midline--I would never do it. If CT power injectes through it and it blows out the vein in the axilla region--it'll be a mess!!! And a potential lawsuit.
I was originally told to cut the power picc to use as a midline, however after research have found out that this is not an acceptable practice. Also it sets you up for litigation if something does go wrong. When cutting a power picc to a midline, the hub on the cath still reads PICC, as well as the clamps have the 5ml/sec injection printed on them. Also as mentioned bard carries a full line of midlines including groshongs in 3 and 4 fr and per q caths in 2,3,4, and 5 fr. The double lumens come in 4 and 5 french only. The kit will need additional supplies added if U/S and MST are used. The following are the supplies I would recommend having- Lidocaine, filter needle, syringe with 25g needle, stat lock, normal saline, MST kit, needle guide kit and full body drape.
I totally agree!! we use Bard midlines too, but we have guidlines, such as 5 days of solumedrol for MS, kefzol iv for 5 days, etc. we also use power piccs from Bard, we do not cut them either, yes you are right picc will still be on hub and this in return would confuse staff. Thanks for sharing!!
I like the BD First Midcath. It is a silicone catheter and I find it is more comfortable for the patient. We do not use a lot of them, I work in the acute hospital setting and most patients are better served with a PICC but we have been using the BD silicone for years and love it!
Is there a place for midlines in the hospitalized pt.? ALso should we use the double lumen midlines ? Is there a risk with infusing incompatibilities medications through a double lumen midline line? Does anyone allow blood draws from a Midline? why or why not?
There is absolutely a place for midline catheters in hospitalized patients. Heparin infusion and the need to avoid multiple venipunctures. Aminophylline infusion for COPD in patients on long term steroids causing changes in skin and vein structure. Geriatrics with urosepsis or pneumonia needing IV fluids and antibiotics whose pH and osmolarity fall within the parameters in the INS standards. Dual lumens may be necessary in some patients but that depends upon the fluids and meds prescribed. The blood flow at the catheter tip of a midline is not the same as the blood flow in the SVC. So there could be some concern for drug contact at the catheter tip. Midlines should not be used for routine blood sampling because the tip is in the peripheral veins that have a smaller diameter. There are not outcomes published with blood sampling through a midline. Lynn
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It has been suggested that we do that as well--It seems to me to be not only an off label practice but one that could prove hazardous if used mistakenly as a PICC for administration of irritants or CT contrast power injection--Surely there must be a good 4FR catheter designated as a Midlne that can be inserted using US
Robbin George RN VA-BC
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
Bard makes the PER Q Cath. It is a silicone catheter. Arrow also has one that is made from polyurethane. They are both 20cm long. You would need to put an MST kit on the field to use ultrasound for insertion. They are very comparable in price. I like the look of the per Q cath--it looks very different and I believe would stand out better--but it is made of silicone. Doesn't chloraprep break down silicone??? I have a question out there about that.
As far as cutting down a power injectable PICC for midline--I would never do it. If CT power injectes through it and it blows out the vein in the axilla region--it'll be a mess!!! And a potential lawsuit.
I totally agree!! we use Bard midlines too, but we have guidlines, such as 5 days of solumedrol for MS, kefzol iv for 5 days, etc. we also use power piccs from Bard, we do not cut them either, yes you are right picc will still be on hub and this in return would confuse staff. Thanks for sharing!!
Lorrie, RN, CRNI, IV TEAM
Owensboro Medical Health System
Cheryl Kelley RN BSN, VA-BC
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