Kelly,
 
Our experience has been the same.  Have had some minimal success with midlines in those patients in our long term facilities that needed access for every other day hydration and slow rates (these sometimes last up to 3 weeks).  Everything else usually starts leaking at the site in a week or under, which could mean the vein thrombosed off above the tip.  Also, they stop aspirating after 4-5 days.
 
Chris brings up an interesting point though - catheter size.  For midlines we are using 4fr silicone catheters with the tip terminating just before the axillary vein.
 
Chris,
 
What size midline catheter are you using?
 
Looks like a great subject for research - Midline catheter size and/or material.
 
Timothy Royer, RN, BSN, CRNI


From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Kelly Murphy
Sent: Saturday, October 14, 2006 7:29 AM
To: Chris Cavanaugh; [EMAIL PROTECTED]
Subject: Re: Midline guidelines from AVA roundtable

This is a little off the original subject, but I have not seen a midline that has lasted the length of treatment yet.  Just yesterday, a patient came to the ED with a midline that was placed 2 weeks ago.  It was leaking at the insertion site.  I spoke with ID and they said he needed 10 more days of IV antibiotics and no, we couldn't change him to PO.  Originally, I was talked into the midline because they weren't sure if he needed 2-3 days or 2-3 weeks, with the promise from both the MD and the PA that if the treatment lasted 2 weeks, the patient would be readmitted.  Being the patient advocate I am, I opted for a midline.
Long story short, I ended up putting a PICC in him yesterday in the ED.  This just reconfirms my belief that midlines are relatively useless except maybe in CMO cases.  Almost every midline I've inserted for home care has come back through the ED for replacement.  Does anyone else feel the same way or have the same experience?
Not trying to start an argument, just wondering if anyone else is having the same results with midlines as me.
----- Original Message ----
From: Chris Cavanaugh <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED]
Sent: Saturday, October 14, 2006 6:54:25 AM
Subject: Midline guidelines from AVA roundtable

For those who could not open the original document posted, here is one as a word document.  Thanks

 

Chris Cavanaugh, CRNI

3606 Molona Dr.

Orlando, FL 32837

407-928-9297

 



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