We are considering the BARD PowerGlide midline catheter as an alternative to PICCs or regular IVs for a specific subset of patients (no irritating medications, pressors, TPN, etc. and need more than 3-4 days of IV therapy). What experience do people have with this catheter?
No midline is an acceptable substitute for a PICC, ever. If a CVAD is needed, a midline is not an alternative. Lynn
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
We are looking at these devices for patients that need access for more than 3-4 days for therapy not requiring central venous access. We find that PICCs are sometimes ordered for IV access, not because the patient needs central venous therapy.
John Hallowell, PA-C, MBA
Director of Physician Assistant Services
Southside Hospital
301 East Main St.
Bay Shore, N.Y. 11706
John, Our team adopted the use of this product after trying several other currently marketed Midlines. Our perspective is that there IS an appropriate subset of patients for which a "bridge" between central and peripheral devices is useful. Some of our findings:
1) Watch that the wire does not slip forward before you insert the device. You can touch the wire delivery button & it will sneak out before you intend it. The manufacturer is reportedly improving this.
2) We no longer use the included securement device. With it, the angle of insertion to the skin creates an opportunity for kinking of the catheter. We've seen this multiple times & reduced the incidence with different securement.
3) Despite the claim for the ability to draw blood from these devices, we've found this to be true for 48-72 hours at best.
We continue to use the product, but it is for a small number of patients. The biggest benefit of having this option available is that it does trigger discussion with the providers so that we can then advise them toward the most appropriate vascular access device.
Anyone is welcome to contact me via email with further questions.
Dave Bruce
PS I have no vested interest in this company or product.
David Bruce RN
David - may I ask what you are using to secure the device that you have had success with?
I agree with Chris! The cost for this product is more than the Medlines on the market. The current midlines maintain ability to draw blood longer. Whereas the ability to draw from a 20g which is about 2.9FR is much less so we pay more and get less. Then you will need the cute little ultrasound so you can use the sterile gel cassettes, which increases your cost more. It is our duty to look at cost containment as we provide our services. Manufacturers have helped us in many ways expand our specialty, but as financial stewards for the organizations that employ us we need to step back and ask do I WANT this or NEED this. In this case I think many will agree this is a WANT not a NEED.
Send me your email address & I will forward an image.
Dave B
[email protected]
David Bruce RN
We are also trialing these mid-lines. We would never use them as a substitue for a "PICC line" but for a specific group of patients that require IV access short term. We are seeing these patients in our ambulatory infusion unit. We would never give Vanc or TPN or pressors thru them, but many antibiotics are perfectly acceptable.
There are many midline catheters available on the market, inserted using MST, which are less expensive then these "power" catheters--why not just use them? Do all of these patients you are using them are require power injection of contrast? Please share your rationale. Thanks
Chris Cavanaugh, RN, BSN, CRNI, VA-BC
I also agreee but I do think there is a need for a power injectable midline.
dsnyrn
If you loose the blood return I would not power inject in this "power midline". More importantly know the osmolality of the agents your organizations uses because there is the posibility of deep tissue injury if an infiltration occurs, some of these patients are intubated and sedated for the CT and unable to say the IV hurts.
Non-ionic[edit]
Non-ionic contrast media have lower osmolality and tend to have fewer side-effects.[citation needed]