First Let's examine why the doctor feels that he needs these midlines:
Do the nurses placing PICC lines use modified seldinger and portable ultrasound or do you have to send a considerable amount of patients to radiology? Is there not enough staffing on your team that you cannot respond to his orders for line placement? Is he not knowledgeable to know that incompatibles cannot go thru a midline or vesicants? The bottom line is to get to find out why he feels he needs to train his ICU nurses to do midlines. What is causing his behavior? By the way the old Landmark articles show that there was a high rate of phlebitis with Vanco. Kathy Confidentiality Notice: This e-mail and any attachments are intended only for the use of those to whom it is addressed and may contain information that is confidential and prohibited from further disclosure under law. If you have received this e-mail in error, its review, use, retention and/or distribution is strictly prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message and any attachments.[v1.0] -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Nauman, Tanya Sent: Friday, September 29, 2006 12:11 PM To: [EMAIL PROTECTED] Subject: Midlines-use in your practice I know this had been discussed previously, but I get an error message today when I try to access "archives". Do any of you routinely place midlines? What are your criteria for placing them? Do you know of any published research supporting (or not) their use in certain situations? Much of the research I've seen had to do with the Landmark catheters. The medical director of our ICU's wants the ICU RN's to learn to place these because we give him such a hard time when he orders them. I think he would have them placed in nearly every patient. He sees no problem with running Dopamine, Vanco, etc. through them...that's why we strongly encourage PICC's and discourage Midlines...but he's sick of us and plans to circumvent us...you can tell I'm upset about this. A couple of years ago I quoted a study (I don't remember which one now), and it was a study done by nursing---he wants Physician studies! I've thought about offering to personally do a study, placing so many Midlines and keeping stats on infusates, medications, outcomes, number of days in place, etc. But, I don't know if this is worth my time, as I think it may just be a power struggle issue and he doesn't want anyone arguing with his orders. Thanks in advance for any input. Tanya ___________________________________________________________ This message is intended solely for the use of the individual and entity to whom it is addressed, and may contain information that is privileged, confidential, and exempt from disclosure under applicable state and federal laws. If you are not the addressee, or are not authorized to receive for the intended addressee, you are hereby notified that you may not use, copy, distribute, or disclose to anyone this message or the information contained herein. If you have received this message in error, immediately advise the sender by reply email and destroy this message.
