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rprice
Multiple Midlines ( Powerglide PIV) - Feedback?

Has anyone had experince with greater than one Powerglide midline?  I was just informed that our cardiac surgeorn is adverse to using PICC's, with a preference to Midlines (Powerglide). His CRNP  requested a second , and the IV nurse complied. 

1.  Would there be any rationale to not have more than one? 

2. Is there any protocol/procedure that that would be different/recommended. 

I have not seen this practice in the past. 

 

Thank you in advance.   

lynncrni
There are numerous clinical

There are numerous clinical situations where 2 peripheral catheters are needed for incompatible medications. The same could be true for a midline. There are dual lumen midlines available however there are no studies reporting outcomes of dual lumen midlines and most experts think it is not wise to use these. A midline is never going to replace a central line and a PICC is a central line. Not sure what issue your cardiac surgeon has with PICCs but there are certainly patients that must have some type of central line and a midline is not going to be acceptable to infuse what is required. 

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

rprice
As always, thank you for your

As always, thank you for your expert advice!

Bobbi Price MSN, RN

mklaas
We do this on a semi-frequent

We do this on a semi-frequent basis. This is generally on patients that require more than one IV site due to incompatibilties. We have had no complications to date from such practice.

M.K.

ICU Nurse

RN, PHRN, VA-BC, NRP

JackDCD
Lynn this is what is

Lynn this is what is happening across the board with PICC usage. Because of the financial "spanking" hospitals take for CLABSI , it's become a stategy to use the MIdline often and without regard to the innate problems that catheter can have.There are countless situations where a PICC would be the appropriate line , but managers are strongly discouraged by upper management to use anything but a central catheter. No central catheter....no CLABSI problem. Sounds logical, at the least from a financial standpoint but what they are turning their backs on is what it means to the patient. I have seen first hand what the damage from improper venous access can do, and have written countless Patient Safety reports as instructed, but to no avail.  Finally, I left because it was just too much. 

lynncrni
Oh yes, I realize this, but

Oh yes, I realize this, but these practices are the exact opposite of what they should be doing. Finally CDC has realized these unintended consequences of this public policy and are looking at some changes. The comment period was over in April but they are looking at revising the definitions of HAI and including all VADs in these definitions. Once that is done, then CMS can look at this financial problem that drives use of inappropriate VADs. 

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

JackDCD
It's about time. I often

It's about time. I often thought .."I wish that all lines were included in reports"...now you say they are considering it....that is great news

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