I was unable to open because I have a different version of publisher. I am 
interested in what the article says. By chance could you put this in word?

Maggie Monahan RN, MSN,CCRN
St Francis Hospital
Columbus GA

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Chris Cavanaugh
Sent: Saturday, September 30, 2006 1:10 AM
To: 'Nauman, Tanya'
Cc: 'venous'
Subject: RE: Midlines-use in your practice


Tanya, I gave a roundtable discussion on this at the AVA conference, I have
attached my handout for you.  This may not help much with your MD, but more
to give you some information.  Midlines are great for homecare and LTC
patients, pts who are on just one type of therapy.  They are not appropriate
for ICU, where multiple drugs are given. They are peripheral IVs,.  Use the
INS standards as to what can be given via a peripheral IV, then show him a
list of pH for the drugs commonly given in your ICU.  You and all nurses are
held accountable for these standards in court, so that should be your
reasons for not having the ICU nurses placed midlines for Vanco, dopamine,
etc.  Lynn Hadaway did a great article on Vancomycin for the INS journal a
few years ago which addressed problems with this drug and why it needs to be
given via central line.  You may also want to show him the AVA tip placement
position paper.   I hope this helps. 

Chris Cavanaugh, CRNI
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Nauman, Tanya
Sent: Friday, September 29, 2006 3:11 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

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