Forum topic

4 posts / 0 new
Last post
kpruitt0413
Discharging Patients with Mid-lines

We are consideing discharging patients with mid-line cathters as appropriate. Length of time antibiotics needed, osmolarity, and appropriate line for patient.

We have quite alot of drug using patients and obviousley the PICC would be a little bigger issue in these patients but how are your facilities deciding on discarge ability with these lines, PICC's and Mid-lines?

Currently is a mid-line acceptable with 6 weeks vancomycin? I had heard the mid-line is good for 29 days (clinically indicated and site condition), and being it's a pheripheral and those lines are referenced in INS as to use as clincally indicated and site condition rather than length of days or time, how is that being handled in your facilities.

I am assuming (which is not the best thing to do) is the mid-line would be as manufactor recommends?

Are there INS standards I am not seeing concerning the use of mid-lines?

I would appreciate any information, as I'm presently looking up information concerning this.

Lynn you have such a vast knowledge of INS Standards and such, I look forward to your remarks.

Thank you so much

Kathy

[email protected]

lynncrni
Dont think I understand your

Dont think I understand your concern about midline vs PICC in IVDA patients. Both provide access if the patient wanted to use it. 6 weeks of vancomycin is far too long for a successful midline to dwell for the entire course. So be prepared to insert multiple midlines. A PICC is the best option. Some manufacturers have misleading statements in the IFU re 29 days. According to FDA, this is a category of devices but it does not represent a max dwell time in any way. It is not based on any clinical studies at all. All VADs are removed when no longer needed for the plan of care or an unresolved complication occurs. See INS VAD Removal SOP. All midlines do not have this 29 days statement. Vancomycin is an irritant and a weak vesicant. Thrombophlebitis is a distinct probability so a PICC would be best to reach end of therapy with a single catheter. 

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

JackDCD
Lynn,

Lynn,

I hear that 29 day rule all the time. I try to explain that it was used as a guideline for length of therapy but they swear by it. So, maybe if you start saying it nurses will get the point. 

lynncrni
Makes me crazy to continually

Makes me crazy to continually hear that! I have been saying it for years but it continues to be a myth may people believe. 

 

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Log in or register to post comments