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Nancy Safranek
Blood draws from midline catheters
I have been recently told (new policy) that blood cannot be withdrawn from midline catheters because they are not in the SVC.  Additionally, we don't place "real" midlines because we don't have any so these are PICC-midlines (secondary to very rare placement failure).  Just looking for a little more opinion/information.  Thanks, Nancy
My advise would be to not

My advise would be to not muddy the water with trying to create new names for the tip locations of catheters.  In the 1990's we went through lots of trials and tribulations coming to consensus on these names. I have no idea what you mean by a PICC-midline. Definitions come from the catheters tip location - ONLY!! PICC is SVC/RA junction. Midline is in the upper portion of the arm, distal to the shoulder, in either the basilic, cephalic or brachial veins. If you are cutting a PICC to be a midline tip location, I would strongly advise against this practice as it is a serious error waiting to happen when a nurse infuses TPN through a midline, that leads to severe thrombosis, possible nerve damage and loss of arm function. It can happen. Midline catheters should not be used for routine blood sampling after insertion. They are located in a peripheral vein with a smaller diameter than the SVC. Blood flow is slower and you could greatly reduce the life of the catheter. 


Lynn Hadaway, M.Ed., RN, BC, CRNI

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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