Yes, but this is the max for peripheral infusion and the osmolarity is 544, so it is still on the high side. Be extremely mindful of extravasation because this can lead to tissue necrosis. Small gauge catheter in as large a vein as possible. This does not require an 18 gauge garden hose!! Lynn
a 7 y.o. is getting D12.5 plus vanco q6hr through a midline. (tip at axil vein because of unable to advance when a picc was attempted.) it was argued it was 'safe' because D12.5 can be infused through piv ... ... I would imagine that a midline infiltration is harder to detect that a piv. but I am losing the battle.
the pt is to get a new tunneled CVC Monday. pt is tpn dependent, came in for line infection.
for a total of 3-4 days, is it safe enough to infuse D12.5 + Vanco through a midline?
There is really no way to answer your question about is is "safe enough". In this and every case, you have to look at all your options and make a risk vs benefit assessment. What are the patients risk factors? We know that the axillary vein is absolutely *not* the tip location for a midline catheter. We also know that hyperosmolar fluids like D12.5 and meds like Vanco (vesicant and with a pH of less tha 4) should not go through these lines. Then consider the alternatives for this patient and make the best choice. There is never a single answer that will work in all cases. But 12.5% dextrose has an osmolarity greater than what should ever be infused through a peripheral vein, although I do know that some NICU's do it. Lynn
Yes, but this is the max for peripheral infusion and the osmolarity is 544, so it is still on the high side. Be extremely mindful of extravasation because this can lead to tissue necrosis. Small gauge catheter in as large a vein as possible. This does not require an 18 gauge garden hose!! Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
a 7 y.o. is getting D12.5 plus vanco q6hr through a midline. (tip at axil vein because of unable to advance when a picc was attempted.) it was argued it was 'safe' because D12.5 can be infused through piv ... ... I would imagine that a midline infiltration is harder to detect that a piv. but I am losing the battle.
the pt is to get a new tunneled CVC Monday. pt is tpn dependent, came in for line infection.
for a total of 3-4 days, is it safe enough to infuse D12.5 + Vanco through a midline?
There is really no way to answer your question about is is "safe enough". In this and every case, you have to look at all your options and make a risk vs benefit assessment. What are the patients risk factors? We know that the axillary vein is absolutely *not* the tip location for a midline catheter. We also know that hyperosmolar fluids like D12.5 and meds like Vanco (vesicant and with a pH of less tha 4) should not go through these lines. Then consider the alternatives for this patient and make the best choice. There is never a single answer that will work in all cases. But 12.5% dextrose has an osmolarity greater than what should ever be infused through a peripheral vein, although I do know that some NICU's do it. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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