What Is a Midline Catheter?

Peripherally inserted central catheters (PICC), which are central lines, and midline catheters, which are peripheral lines, are two types of vascular access devices (VAD) that are used frequently and are often confused with one another. The patient’s diagnosis, the predicted span of time the line will be required for therapy, the type of infusion needed, and the cognitive and intellectual level of the patient or caregiver are all considered when deciding which type of VAD the patient will need. PICC lines are typically chosen when longer lengths of intravenous therapy are needed but both PICC lines and midlines can remain in place for an indeterminable amount of time provided they are properly monitored for complications.

What is a midline catheter used for?

A Midline is used for intravenous treatments of more than 6 days, prolonged therapies (cardiological or antibiotic for serious infections), for nutritional or hydro-electrolytic support or in cases where a central venous catheter can lead to immediate complications for the patient.

What is a midline catheter vs PICC?

PICC lines are placed into a vein in your arm, and then guided into a larger vein in your chest. A midline catheter is put into a vein by the bend in your elbow or your upper arm. The midline catheter tube is shorter than a PICC line. The midline tube ends in a vein below your armpit.

How long can a midline catheter stay in?

The Infusion Nurses Society (INS) classifies midlines as peripheral I.V. catheters, but they’re managed somewhat differently than other peripheral catheters. For example, while a short peripheral catheter may dwell for up to 72 hours, a midline is appropriate for therapy lasting 2 to 4 weeks.

Is a midline catheter A central venous catheter?

Unlike PICC lines, Midline catheters offer peripheral, not central venous access. Midlines should be considered early in treatment instead of serial short peripheral IVs.

A midline catheter, defined by Infusion Nurses Society, is a vascular access device intended for placement into a peripheral vein in the upper arm; basilic, cephalic, or one of the two brachial veins, with the internal tip located level at or near the level of the

Use a midline catheter for medications and solutions such as antimicrobials, fluid replacement, and analgesics with characteristics that are well-tolerated by peripheral veins. Assess the clinical benefit of using a midline catheter that inhibits bacterial attachment and biofilm formation.

Avoid the use of a midline catheter when the patient has a history of thrombosis, hypercoagulability, decreased venous flow to the extremities, or end-stage renal disease requiring vein prevention. ICU Management Practice states ultrasound guidance allows clinicians to see their anatomical target and surrounding structures, such as soft tissue, vessels, and nerves in real time as the needle advances to the procedures endpoint, instead of working blindly.

Current clinical practice is characterised for importance of the patient’s quality of life and the need to reduce the costs of their treatment. We search intravenous therapy alternatives that meet the needs of the patient, reducing the complications associated with the use of venous catheters. Scientific evidence shows that there are midline venous catheters that offer patients and professionals the possibility of extending the duration of infusion therapy, using more venous compatibility materials, and with less risk of infection. The Midlines are becoming in a safe an efficient device for intravenous therapy, continuous and intermittent infusion, provided the necessary care by expert nurses. Midline catheters are peripheral venous access devices between 3 to 10 inches in length (8 to 25 cm). Midlines are usually placed in an upper arm vein, such as the brachial or cephalic, and the distal extreme ends below the level of the axillary line. Midlines catheters implanted in the cephalic or deep basilica veins get more blood flow. This large blood volume justifies the lower risk of mechanical or chemical phlebitis. Midlines are routinely used for two to six weeks. Due that the extrem of these catheters does not extend beyond the axillary line, there are limitations for its use: type of infused drugs, velocity of infusion, etc. In general, solutions that have pH 5 to 9, or an osmolarity less than 500 mOsm are appropriate for infusion through a Midline. Its use is recommended in case of treatments over 7 days with low irritant capacity fluids. According to the Infusion Nurses Society’s standards of practice, Midline catheters are appropriate for all intravenous fluids that would normally be administered through a short peripheral IV Importantly, due that the catheter does not pass through the central veins, Midlines can be placed without a chest X-ray to confirm placement. For certain situations, Midlines are suitable for acute units and even for care home settings. Midlines have been associated with lower rates of phlebitis than short peripheral IVs, and less infections in contrast to central lines. There are different implantation techniques, which have evolved in terms of materials (silicone and polyurethane) and technological advances (ultrasound): Seldinger technique with micropuncture and Ultrasound-guided Seldinger technique. At present where scientific evidence, clinical needs, efficiency and costs are influential parameters, Midlines should be considered as an alternative peripheral venous access. Unlike PICC lines, Midline catheters offer peripheral, not central venous access. Midlines should be considered early in treatment instead of serial short peripheral IVs. These devices permit the infusion of most or all infusates that are appropriate for short peripheral IVs with the added advantage that Midlines can last much longer; at least six weeks and perhaps for months.

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Midlines are longer than a regular IV. Midlines are usually put into a vein in the arm. Sometimes a leg vein is used for infants. It lasts longer than a regular IV, but not as long as a PICC line. It can usually be used for 2-4 weeks. Midlines are used for medications or fluids that do not irritate veins.

Your child will go to a treatment room with a nurse trained for placing these types of IVs. Your home health nurse will show you how to get air bubbles out of the syringes and medication tubing.

Bleeding: If the line is opened when it is not clamped or connected to a syringe, blood can be lost from the vein. Flushing your childs line per your home health instructions will help to prevent blockage. Infection: Washing your hands before caring for your childs line is very important.

Using good hygiene for changing the dressing and caps can also decrease the risk of infection. Phlebitis: If you notice your childs vein feels like a cord and is warm and painful to touch, the line may need to be removed by the doctor or nurse. Catheter migration: Keep the bandage secure and follow the activity limitations.

No tumbling or rough play No repetitive arm movements such as bouncing a ball Avoid activities that will get the bandage dirt Disclaimer : This information is not intended to substitute or replace the professional medical advice you receive from your child’s physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease.

Please consult your child’s physician with any questions or concerns you may have regarding a medical condition.

When to Choose Midlines for Your Patient

The CDC recommends catheters are selected based on the intended purpose and duration of use, known infectious and non-infectious complications, and experience of individual catheter operators. INS Guidelines indicate 6 considerations when choosing midline catheters for your patient:

Abstract

Current clinical practice is characterised for importance of the patient’s quality of life and the need to reduce the costs of their treatment. We search intravenous therapy alternatives that meet the needs of the patient, reducing the complications associated with the use of venous catheters. Scientific evidence shows that there are midline venous catheters that offer patients and professionals the possibility of extending the duration of infusion therapy, using more venous compatibility materials, and with less risk of infection. The Midlines are becoming in a safe an efficient device for intravenous therapy, continuous and intermittent infusion, provided the necessary care by expert nurses. Midline catheters are peripheral venous access devices between 3 to 10 inches in length (8 to 25 cm). Midlines are usually placed in an upper arm vein, such as the brachial or cephalic, and the distal extreme ends below the level of the axillary line. Midlines catheters implanted in the cephalic or deep basilica veins get more blood flow. This large blood volume justifies the lower risk of mechanical or chemical phlebitis. Midlines are routinely used for two to six weeks. Due that the extrem of these catheters does not extend beyond the axillary line, there are limitations for its use: type of infused drugs, velocity of infusion, etc. In general, solutions that have pH 5 to 9, or an osmolarity less than 500 mOsm are appropriate for infusion through a Midline. Its use is recommended in case of treatments over 7 days with low irritant capacity fluids. According to the Infusion Nurses Society’s standards of practice, Midline catheters are appropriate for all intravenous fluids that would normally be administered through a short peripheral IV Importantly, due that the catheter does not pass through the central veins, Midlines can be placed without a chest X-ray to confirm placement. For certain situations, Midlines are suitable for acute units and even for care home settings. Midlines have been associated with lower rates of phlebitis than short peripheral IVs, and less infections in contrast to central lines. There are different implantation techniques, which have evolved in terms of materials (silicone and polyurethane) and technological advances (ultrasound): Seldinger technique with micropuncture and Ultrasound-guided Seldinger technique. At present where scientific evidence, clinical needs, efficiency and costs are influential parameters, Midlines should be considered as an alternative peripheral venous access. Unlike PICC lines, Midline catheters offer peripheral, not central venous access. Midlines should be considered early in treatment instead of serial short peripheral IVs. These devices permit the infusion of most or all infusates that are appropriate for short peripheral IVs with the added advantage that Midlines can last much longer; at least six weeks and perhaps for months.