We cut our above the AC Midlines to a length of 10cm and have been very successful with this approach
--
Robbin K. George RN
Vascular Access Resource
Alexandria Hospital Virginia
[EMAIL PROTECTED]
Robbin K. George RN
Vascular Access Resource
Alexandria Hospital Virginia
[EMAIL PROTECTED]
-------------- Original message --------------
From: "Alma Kooistra" <[EMAIL PROTECTED]>
> Amen. I agree completely.
>
> I have a question though.......we have been using Ultrasound for PICC
> placement since April 1. We're doing OK with this (thanks in part to the
> good support and encouragement I've received from my benefactors on the
> listserve), but when I place a midline I'm reluctant to go above the AC
> space due to the tip of the catheter finding itself potentially above the
> axilla. We only place midlines for our short-term access patients, and
> because of that I've just been inserting them at the AC space. Aren't you
> concerned about tip location when you insert midlines higher up the arm?
>
> Alma Kooistra RN, CRNI
>
>
>
>
> ----Original Mess age Follows----
> From: "Michael Drafz" <[EMAIL PROTECTED]>
> To: [EMAIL PROTECTED], [EMAIL PROTECTED], [EMAIL PROTECTED],
> [EMAIL PROTECTED], [EMAIL PROTECTED]
> Subject: Re: Midline guidelines from AVA roundtable
> Date: Sun, 15 Oct 2006 18:36:49 -0700 (PDT)
>
> We are placing 30-40 Midlines every month. We do assess indications (drugs,
> lenght of therapy, diagnosis) very carefully. So if a MD orders a ML and
> there is a PRN for Phenergan for example, even if the patient has never
> gotten it, we will not place that line. Same with Vanco or other Vesicants.
> We have them change the drug(if possible -especially with Phenergan) or they
> need to change their order to a PICC.We have very little complications,
> especially since we are using ultrasound for Midlines as well and trying not
> to use the AC. We do lot's of education with the staff and they usually know
> what is appropriate. We follow all our lines for the maintanance care and
> can pick up if there are issues.This is certainly not true everywhere and
> that should influence what line you utilize in your facility.
> But there is a handful patients for whom a Midline is a good option.
> Don't we try to do the least invasive line to accomodate the therapy? I
> belive that this is another reason why we need to stand up for ourselves as
> specialists in Vascular Access. It would be great if most healthcare
> providers have the knowledge to assess all the factors about line placement,
> but reality is that the number is getting less and less.
> I also don't believe in "one fits all" and agree that unless there is
> good data proving that Midlines which have been placed for appropriate
> therapy and been inserted and cared for by a trained professional have
> mostly bad outcome, I don't see why we should depri ve some patients of that
> option.
>
> Michael Drafz
> San Diego
>
> [EMAIL PROTECTED] wrote:
> No,
> I have not seen the same thing.
>
> --
> Randy Ross R.N., B.S.N.
> IV Nurse Consultant,
> President & C.E.O.
> IV's Etc... LLC
> Vascular Access
> & Consulting
> Ph: 317-541-6463
> Fax: 317-894-7709
> Email: [EMAIL PROTECTED]
> Website: www.IVsEtc.com
>
> -------------- Original message ----------------------
> From: [EMAIL PROTECTED]
> > Yes, I have seen the same thing.
> > Leigh Ann
> >
> >
> > -----Original Message-----
> > From: [EMAIL PROTECTED]
> > To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
> > Sent: Sat, 14 Oct 2006 10:28 AM
> > Subject: Re: Midline guidelines from AVA roundtable
> >
> >
> & gt; 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
> may be 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
> > 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
> >
> > _____________________________________________ ___________________________
> > Check out the new AOL. Most comprehensive set of free safety and security
> > tools, free access to millions of high-quality videos from across the
> web, free
> > AOL Mail and more.
>
>
>
> From: [EMAIL PROTECTED]
> To: [EMAIL PROTECTED],
> [EMAIL PROTECTED],
> [EMAIL PROTECTED]
> Subject: Re: Midline guidelines from AVA roundtable
> Date: Sat, 14 Oct 2006 17:07:07 +0000
>
> Yes, I have seen the same thing.
> Leigh Ann
>
>
> -----Original Message-----
> From: [EMAIL PROTECTED]
> To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
> Sent: Sat, 14 Oct 2006 10:28 AM
> Subject: Re: Midline guidelines from AVA roundtable
>
> .AOLPlainTextBody { margin: 0px; font-family: Tahoma,
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> height: 206px ; background: #F4F4F4 center center no-repeat;
> border: 1px solid #DADAD6 !important; } 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
>
>
>
>
>
>
>
>
>
> ---------------------------------
> Check out the new AOL. Most comprehensive set of free safety and security
> tools, free access to millions of high-quality videos from across the web,
> free AOL Mail and more.
>
>
>
>
> Michael Drafz RN, OCN, CRNI
> Clinical Lead Vascular Access Service
> Sharp Memorial Hospital Metropolitan Campus
> San Diego, California
>
>
>
