I totally agree with you Cindy.  At least you can see an extravasation pretty much immediately with a peripheral IV site, a midline would not be seen until extensive damage had already been done.  If Bard oked this, they should think that over a little.  I would also like to see that OK in writing.  I would not want to be on the receiving end of a lawsuit like that!
 
Heather Nichols RN BSN CRNI
Infusion Services
University of Louisville Trauma Institute
530 S. Jackson St.
Lou. Ky. 40202
(502)562-3530

>>> "Cindy Schrum CRNI" <[EMAIL PROTECTED]> 3/7/2006 5:28 PM >>>
Why is it ok to power inject a vesicant when it's not ok to infuse a vesicant through a midline?  Somebody needs to help me with this one!

Cindy Schrum RN CRNI
IVTeam Coordinator
Gaston Memorial Hospital
Gastonia, North Carolina
(704) 834-2707

>>> "Richard Pearson" <[EMAIL PROTECTED]> 3/7/2006 3:43 PM >>>
At our hospital the IR docs now do all PICC lines. There are still a couple of us former PICC nurses who occasionally place midlines since it doesnt require a trip to radiology.  We do occasionally place a 'power' midline by using a 5Fr single lumen power picc and cutting it to midline length.  I do the same procedure as if I was placing a PICC except that I cut the power picc at the 20 cm mark prior to insertion.  You have to pull back the stiffening stylet so you arent trying to cut that as well and then it sticks out and creates problems with maintaing a sterile field.   Last time I took the stiffening stylet clear out and that worked better.  I then insert it to the 5 cm mark, so 15 cm is in the patient.  After I am  done I use a sharpie marker to mark 'midline' on the dressing and on the skin, otherwise people will assume it is a PICC instead of a midline.  Then they can use this for CT contrast if needed.   It works fine, but of course you have the limitations of a mid!
line--no good for vancomycin, TPN, etc. 






Rich Pearson RN MS CCRN
Clinical Nurse Specialist
Intensive/Post Intensive Care
Alegent Health-Immanuel Medical Center
Omaha, Nebraska
402-572-3433


>>> "julie bryant" <[EMAIL PROTECTED]> 3/7/2006 12:30 PM >>>
We have always used single lumen 4fr cathteters for Midline insertions at my facility.
  Are there any contraindications to using a 5FR single lumen Midline?
  Contemplating using the single lumen 5fr power PICC and cutting for Midline.
  Thank you.
  Julie

       
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