a 2 m.o. got admitted for infected thrombosis R IJ
secondary to R IJ central line.
ultrasound confirmed complete occlusion R IJ, partial
occlusion right innominate.
ID recommend 4 weeks abx iv.
parents (both MDs) want to go home. they don't want
picc or any central line because of BAD experience
(can't blame them).
Dad wants home piv for abx (he is an anesthesiologist
himself). my concern is delayed or absence abx
treatment if IV access lost at home.
So now we settle with midline -- I did explain to them
the risk of thrombosis from midline vs picc.

so if I place a midline left AC, it will be about 5 cm
internal length.
if I choose saphenous, should I leave the tip @ the
fem vein?

I don't see the best solution for this case. I had
thought that piv would be the safest -- for in-house
care. However, piv doesn't seem like an optimal option
for home care -- the baby is a difficult stick -- why
he ended up with an IJ in another facility in the
beginning.

please advise

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