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Use of midline catheters

Reading the 2021 INS standards regarding midlines. On Standard 41.1 Flushing and locking it states all VADS must be flushed and obtain a blood return prior to each infusion. This would indicate PIVs as well as Midlines? Just want to confirm I'm reading this correctly as this would indicate the midline or PIV would need to be removed. Please advise as we are being directed towards use of the midline over a CVAD.





You are reading it correctly.

You are reading it correctly. Checking for a blood return is one component of a complete assessment of any VAD, including all PIVCs - short, long, and midline. Observation of the site and dressing; palpation of the site for induration, temp changes; flushing and aspriation for a blood return; and seriously listening to all patient complaints. That is a full assessment. Now if there is no blood return, the question is what action do you take? That depends on many factors and your judgment. How old is the site? What is being infused through it - vesicant, irritant nature? Other signs or symptoms of complications such as pain, leaking, etc? Can you scan the tip area with infrared light (superficial veins) or US (deep veins) to see if fluid is entering the tissue? Answers to all of these will tell you if it is safe to continue or to remove it.  

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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