We are in the process of ordering midline kits. I would like to know experiences with the Bard groshong midline vs Bard per q cath midline. Anyone out there with pros and cons of either?
Please forgive me if I sound like a "commmerical" for Bard, but I love the Groshong MIdlines.. We often place Midlines for 10-14 days of Rx. There are several advantages that I found over the the Per-Q-Cath.
#1. Being a valved IV catheter, one only needs NSS to maintain its patency.
#2. By avoiding an open ended IV catheter, you can avoid introducing heparin into the venous system, and thus avoid HIT.
#3. If a pinhole develops or if its hub accidentally breaks off, the Groshong ML is easily repaired. (yahoo) We work with numerous Geriatric patients and this is a frequent occurance.
Cons : It doesn't appear to be as strong (tensile strength wise) as the Per-Q-Cath.
Hope this helps
I agree with Diane totally
I was unaware that they sell Groshong "midlines". Our infusion center has cut the 3Fr. PICCs to make them midlines. Seems like it would be safer and cheaper to order just a Groshong midline.
No PICC should ever be cut to create a midline as this is creating a risk for serious mistakes. This is especially true when the word "PICC" is stamped on the external segment. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Office Phone 770-358-7861
You asked about the differences between those two catheters:
Groshong is a closed catheter, with valves at the distal tip. It is made of silicone. You trim the proximal end and add the hub.
PerQ Cath is a polyurethane, open ended catheter. If you choose to trim, you are trimming the distal end which is threaded through the veins.
Those differences and the pros and cons of each are the same with PICCs and Midlines...
By the way, there are other companies who make midlines, besides Bard.
Regarding a previous comment of "just cutting a PICC" a few cautions: Not everyone agrees (including INS) that trimming a catheter at all is a good idea, it creates a rough surface that is thrombogenic, more prone to clotting and rough on the tunica intima epithelial lining. Cutting a PICC and placing it as a midline is OFF LABLE use, therefore if there is a complication, liablity will fall on the inserter. If the catheter is labled as a PICC and it is not, there is a very high risk of something being infused that should not be, such as a vesicant.
Chris Cavanaugh, RN, BSN, CRNI, VA-BC
We are now using the BD First Midcath with the Maxplus cap and have good outcomes with them. We were using the Bard midlines and found that they kinked off at the connection site quite frequently causing distal occlusions. The only problem we have is we can't find a good securement device to fit them. We currently secure them with steri strips.
Cheryl Perry RN,CRNI
Cheryl, One choice would be the Grip-Lok WA (wide adhesive).The picture on the Grip-Lok manufacturer’s page shows the Grip-Lok being used with what looks to be a BD First PICC or a BD First MidCath. See http://www.zefon.com/medical/product.php?productid=1001&cat=0&page=1The MidCath is a silicone catheter and the Grip-Lok manufacturer specifically states that Grip-Lock can be used to secure silicone hubs.
Another choice would be: Stat-Lock makes a product that is specifically designed for the BD First MidCath. Here is a link with a picture and some information about the FIRST Statlock Stabilization Device.http://www.venetec.com/product_first.html
A third choice would be Sorbaview Shield. http://www.sorbaviewshield.com/It has a catheter stabilization built into its transparent catheter dressing. It comes in three different sizes. You could ask the Sorbaview Shield manufacturer which size they would recommend for the MidCath. Here is a brochure with the product details: http://www.sorbaviewshield.com/downloads/LIT-SVS-500_SorbaView_SHIELD.pdf
WingGuard by Centurion and The Bone by Nexus Medical are two other catheter securement devices. I do not know if they are compatible with the MidCath, but you could check with the manufacturers. Product information is at http://www.tristate.com/NoMenuPages/Catheter-Securement-PDFs.aspx and http://www.the-bone.com/
INS standard #43 B states that using a manufactured catheter stabilization device is the preferred way to secure a catheter.
Hope that helps./Tess Hopkins
Thanks so much Tess for all the info. :)