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Gina Ward
Midlines; time out, removal of line



Are you all performing a "time out"  prior to Midline insertion ?    Because these are considered a peripheral IV we have not been doing such.   But, I believe I read somewhere  that teams were. 


Removal of a midline;   we typically remove the catheter, using gauze hold pressure until hemostasis achieved then tape the gauze to site and finished.   Recently I was reading where people were utlizling the same dressing and procedure as when removing a PICC line for air embolism prevention.     What  is the data or evidence on this??  Is it needed?


Thanks in advance,  Gina Ward RN, VA-BC

There is a lack of evidence

There is a lack of evidence to answer either of your questions. RE the time out, I would follow the advise from the risk management in your facility. A PICC is a CVAD. A midline is a peripheral catheter. The risk of venous air embolism is associated only with intrathoracic pressures. Pressure in peripheral veins is higher than intrathoracic pressures, so for air embolism to occur with any peripheral catheter, there has to be something forcing air into the vein - such as power injector pump, a pressure bag, or a manual injection from a syringe. Removal of a midline will not have any such pressure. PIVC removal requires hemostasis. Any CVAD removal requires hemostasis and prevention of air embolism. 

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

Gina Ward
Thank you so much.   I love

Thank you so much.   I love it when I am on the same page as you Lynn.  

Gina Ward R.N., VA-BC

aileen rogers
midline consent

We do not get written consent as it is a peripheral IV as this is what our Rick Management recommended.  However, we do obtain verbal consent and document this in our Procedure note.

Aileen Rogers RN BSN VA-BC

IV Team Resource Nurse






Gina Ward
thanks for your response.  We

thanks for your response.  We only obtain verbal consent as well,but....  I dont actually document that I obtained verbal consent persay.  Great point.  thanks,

   I was wondering about time outs with insertion of Midline.

Gina Ward R.N., VA-BC

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