Yes Lynn, In addition a whole heck of a lot of physician education. Hard to control when they change meds. Bob
>>> Lynn Hadaway <[EMAIL PROTECTED]> 2/4/2006 11:16:39 AM >>> Or we need some good clinical data upon which to base our decisions about their use. Lynn At 10:45 AM -0700 2/4/06, Robert Nohavec wrote: >I too agree with all. Dual lumen midlines should be ommitted from >practice. I would rather place 2 single lumen midlines >Bob > >>>> "Lynn Hadaway" <[EMAIL PROTECTED]> 2/4/2006 7:51:01 AM >>>> >I share your concern about dual lumen midlines as I am not aware of >any clinical studies using them. Midline tip location is always level >with the axilla and never extends into the shoulder area, regardless >of the insertion site. Midlines also require a careful assessment of >the pH and osmolarity of solutions which should be the same as any >other peripheral catheter. Midlines can replace multiple peripheral >catheters for some patients but they are never a replacement for a >central line. Lynn > >At 8:15 AM -0500 2/4/06, Cindy Schrum wrote: >>Nancy, We may put in 10-15 Midlines per month. Leaking at the >>insertion site is usually one of the signs of thrombus. The fluids >>are retrograding back down the pathway of the vein. We use MST/US, >>basilic or cephalic, about 1" above the AC. >> >>I dont' use anything bigger than a 3fr (smallest catheter, largest >>vein). If you use a dual, you can only infuse meds that are Y-site >>compatible because the tip is not central. So I believe duals >>shouldn't be used. >> >>Tip should end at the axilla. No further for Midline placements. >>Hope this helps! >> >>Cindy Schrum CRNI >> >>On 2/3/06, Nancy Sullivan <[EMAIL PROTECTED]> wrote: >>> Here goes some question about Midline. >>> My hospital IV team (that I am on) has stopped putting in midlines >because >>> we were experiencing leaking at the insertion site. >>> Is any one else experiencing this problem. >>> Also, Do you place them in the ac or upper arm? >>> Do you use MST and or ultrasound to place a midline? >>> Where is the tip if you use the upper arm? >>> We use Bard 4fr groshong ad 5fr dual per q cath midlines, that is >if we >>> happen to put one in. >>> Thanks >>> Nancy >>> >>> >>> ________________________________ >>> Brings words and photos together (easily) with >>> PhotoMail - it's free and works with Yahoo! Mail. >>> >>> > > >-- >Lynn Hadaway, M.Ed., RNC, CRNI >Lynn Hadaway Associates, Inc. >126 Main Street, PO Box 10 >Milner, GA 30257 >http://www.hadawayassociates.com >office 770-358-7861 -- Lynn Hadaway, M.Ed., RNC, CRNI Lynn Hadaway Associates, Inc. 126 Main Street, PO Box 10 Milner, GA 30257 http://www.hadawayassociates.com office 770-358-7861
