We use Bard PowerMidlines when the Mds dont want PICCs. They seem to not give us a blood return after 2-3days. Would it help to use heparin in them. They have a clamp so dont think they are valved. I read the literature and it does say flush with saline. It also says we can tPa them. Anyone have any advise or use these on a regular basis
Hi lanstan,
This is an ongoing problem with the Midlines. We use another brand and after 1-2-days they clot. We are seeing more and more Midline use especially when organizations are limiting the use of PICC lines. There are others that say clotting in a Midline should NOT be occuring, however, I assure you it is. The TPA question is still inrresolved and I suspect will be for a while. Why you can't use Cathflo on a Midline is not clear to me, but as we continue to cut out the PICC and use Midline as the go to line, I think we will see Midlines get Cathflo approved. Good luck with your problem but just know you are definitely not alone
Jack
What vein is being used? Basilic is largest diameter. What is catheter to vein ratio? Catheter should consume less than 45% of vein lumen, measured by US. Where exactly is tip location? It should be level with the axilla or arm pit and never located in the shoulder. Are you measuring between venipuncture site and tip location and inserting only that length of catheter? Are you certain the obstruction is caused by intraluminal thrombus? The responsibiity to add midlines to the Cathflo instructions for use would be up to the Cathflo manufacturer. They would need to present outcome data to the FDA to change the labeling. I don't see that happening, however there is clinical research happening now with Cathflo in midlines. As soon as that is published, you will have some outcome data for your facility committees to use for a decision about Cathflo in midlines. Midlines work well for many locations but your problems need lots more evaluation.
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