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stemc
Need Midline Policy please

Does anyone have a midline policy that they can share with us.  Right now we place only PICC lines and we use Bard Power Picc's.  We are looking into creating a policy for placing midlines.  Can anyone also tell me which type of picc you use for midlines.  Thank you.  You can email us at [email protected]

lynncrni
I am confused - 'which type

I am confused - 'which type of PICC you use for midline" ?? You should never to cutting a PICC to a midline length. The external label will still say PICC, so this is leaving you and your hospital open for serious liability when an inappropriate solution is infused through the catheter labeled as a PICC but not in the central circulation.  There are brands of midline catheters with the proper external labeling and these should be used for all midline placements.

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

www.hadawayassociates.com

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

stemc
Sorry for the confusion I
Sorry for the confusion I guess I meant to say what type of "catheter" do you use for midlines.  I am sorry we don't really know much about midlines and are just trying to gather information and learn a little bit more about them.  I do realize that cutting a power picc and using it as a midline is not a good idea and nurses will mistake them for a PICC that is why we don't do them.  I am just looking for what people like as far as midline catheters go, if they work well, actually any info would help.  We have heard from other hospitals in our area to stay away from them, so we are looking to see what other opinions there are out there.
lynncrni
Well, I am a little

Well, I am a little prejudiced in favor of midlines because  I wrote the instructions, classes, etc for the first midline introduced to the US market. I strongly believe they are a viable option for vascular access in some patients. They should only be regarded as a replacement for repeated peripheral catheters in patients who meet the criteria in the INS standards of practice. They should never be regarded as a replacement for CVCs. That has been the problem - when a hospital tried to make them work for therapies that were not appropriate. What is not appropriate - all vesicants, pH below 5 or above 9, and osmolarity greater than 600 mOsm. This requires an infusion nurse specialist to do a patient assessment for the most appropriate vascular access for each patient. 

 

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

www.hadawayassociates.com

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

momdogz
We rarely use midlines, but

We rarely use midlines, but there are a few indiations they're perfect for - MS patients admitted for a few days of IV steroids; pts with poor peripheral access needing a few days of IV fluids, etc.  We've also used them for patients with poor peripheral access that needed blood transfusions and/or lab draws for a day or two.  Arrow and Bard both make midlines.  Bard has both non-valved midliness, and groshong valved midlines. 

Mari Cordes, BS RN 

Nurse Educator IV Therapy
Fletcher Allen Health Care, Burlington VT
Educator, Bard Access Systems 

Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

Chris Cavanaugh
Midlines are a great

Midlines are a great alternative to multiple PIVs, and are made by Arrow, Bard, and BD and there may be others.  Midlines are used very commonly in homecare, long term care (nursing homes) and in the outpatient setting, including MD offices that do infusions.  When using Midlines in the acute care setting, it is important to use a product that is clearly labled at or near the hub as a midline, to reduce the chance of the line being confused as a PICC.  Hospitals that have been successful in using midlines also are very diligent with education of the general nursing staff, as far as what they look like and how they can and cannot be used, place signs on charts, over the beds or on them, and also lable the dressing to indicate Midline, not PICC.  

Chris Cavanaugh, CRNI

Chris Cavanaugh, RN, BSN, CRNI, VA-BC

tdinvamed
Another source of Midlines

Another source of Midlines is from Neo Medical Inc in Fremont, CA. The 5.0F DL and 3.9F DL feature staggered exit ports decreasing the risk of harmful drug interactions and allow for the safe infusion of incompatible drugs and solutions. These two catheters also come with expanding side port technology that eliminates vacuum created between the catheter and the vessel wall, allowing blood draws through either lumen relieving pressure during infusion. Midlines offer a less invasive and more cost effective vascular access option for patients who require 1-2 weeks of non-irritating IV Therapy. Watch for a new feature being added this summer designed to help eliminate confusion between a PICC and Midline in the care setting. (www.neomedicalinc.com)

Tim Duvall

President, Neo Medical Inc.

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