I am wondering how other institutions are handling INS guideline in reference to PH of IV solutions that are appropriate for a peripheral infusion. The statement that any solution with a PH less then 5 or greater then 9 is inappropriate for peripheral infusion covers so many solutions. I totally understand for solutions that are very harsh like phenergan, vancomycin or dopamine but D5.45 with 20meq of K+ also has a PH of less then 5. I don't believe these guidelines are followed strictly or almost every patient would require a central line. Please share how your institution handles this issue. Do you have a list of infusions that cannot be given peripherally, and if so do your physicians adhere to the list. Can you share the list? We have just introduced a new Midline catheter at my facility and this has sparked much discussion on this topic between bedside nursing, pharmacy and physicians.