I believe one of the issues is what is the midline being used for.
One reason peripheral catheters have been successfully used for blood draws when
initially inserted is that these lines are short term. With catheters that
have extended dwell times, it is important to minimize reflux into the
lumen. Fibrin build-up on the internal wall sets up an environment for
bacterial adherence and subsequent colonization with biofilm development.
Sometimes a short term solution may have a long term affect. The continual
issue that arises for vascular access nurses it developing that individualized
plan of care. This includes weighing the risk vs benefit for each
decision. What may be reasonable in one situation may not be reasonable in
another.
----- Original Message -----
Sent: Friday, August 11, 2006 12:21
AM
Subject: Re: Lab Draws from Mid-line
Catheters
I have to agree with Chris. Our group places
lines in patients in hospitals, rehab facilities, and LTC facilities. If
the catheter gives a good blood return, and you don't have any other good
options, why wouldn't you use the midline? Some midlines won't give you
a good return. Some PICC's won't give a good return either! The
vein where the midline terminates is larger than the AC veins used for
99% of labdraws that occur with peripheral sticks. I would much rather
use a midline that draws well, along with appropriate flushing of course pre
and post draw, than have the patient go through multiple unsuccessful attempts
just to avoid using the Midline catheter. I have been an IV nurse for 21
years, and have not seen problems with this practice.
Here's a great idea for someone's poster at
the AVA or INS convention.
Halle Utter
Intravenous Care, INC
----- Original Message -----
Sent: Wednesday, August 09, 2006 5:20
PM
Subject: Re: Lab Draws from Mid-line
Catheters
Are there any studies NOT to suport this practice? Short PIVs are
in a SMALLER peripheral vein and are used for blood draws when they are
new. I have successfully drawn labs from Midlines, in homecare and
LTC. Sometimes, this is the ONLY option you have, as the patient is too
bruised (usually my LTC pts) or have too small, spidery veins that are
difficult to access and actually get enough blood for a sample from.
It may not be the best choice, if the pt has a good AC, I would recommend a
peripheral draw from there, but if not...
I would flush before and after w/10cc NS and heparin if needed after, and
draw slowly. Some will give a vigorus blood return, some will not give
any at all.
Chris Cavanaugh, CRNI
----- Original Message
-----
From: Lynn Hadaway <[EMAIL PROTECTED]>
Date:
Wednesday, August 9, 2006 6:00 pm
Subject: Re: Lab Draws from Mid-line
Catheters
To: "Thompson,Judith C" <[EMAIL PROTECTED]>,
"'[EMAIL PROTECTED]'" <[EMAIL PROTECTED]>
> It should not be
done. No studies support this practice. Midlines
> are
> in a
peripheral vein with a much smaller diameter than the SVC and
> no
> data on what this practice will do to the survival of the catheter
> until end of therapy. Lynn
>
> At 11:54 AM -0700
8/9/06, Thompson,Judith C wrote:
> >I'd love to hear your view
point's on drawing labs from Mid-line
> catheters?
>
>
--
> Lynn Ha! daway, M.
