We are going to be placing more midlines with all the new information given to us reguarding inapropriate use of PICC's. We do not have power midlines so that is why a lot of Drs and RN's dont want midlines. We have the option of getting power midlines with a microintroducer (what some people call the "true midline") or the new powerglides or something like that. We place non power midlines now. Cant I get feed back on what people like the most. INS standards (I believe) want full sterile field for midlines so I am not sure I see the advantage of the newer ones. I like to see that my wire goes in easily before I thread the catheter. Been doing PICCs/Midlines for 8 years. I worry about the new ones as I feel people will get sloppy placing them and everone will want to do them. It worries me about the infiltrate rates in those large arms that one would have trouble identifying.
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Infiltration is directly related to the catheter length. Are you measuring vein depth in addition to length and diameter? All are important. Catheter length should have at least 2/3 inside vein lumen. Use of deep veins (brachial, basilic) or bariatric patients would have a higher risk if the catheter is too short.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
This is a perfect example of how an industry changes. There is nothing wrong with the Midline however, the industry saw a need for a new "peripheral "type of line that can have the ease of insertion with the durability of the Midline. With everything I've read, you don't need a full barrier to place the powerglide, hence, the peripheral IV like advantage. Here's where I see the problem heading. Everyone is going to want to put these in. Anyone taught to find a vein with US will think they can insert these catheters. I think that is the alarming trend. In my practice I see alot of US guided peripherals being inserted and even Lynn stating it should be an experienced vascular access nurse, hospitals just are not doing that. So whats happening is we are watering down a skill.So, you will see alot of powerglides being inserted.
But I have a seperate question....everything is power rated nowadays. Why are you using non power Midlines?