There was an outstanding article in the JIN around a year or so ago
(somebody, help me out) that was done re use of midlines. It was very good,
and I used it for education. Of course now it's late at night and I don't
know what I did with it. Please someone, reference it so these people can
benefit.
FYI......we do use midlines, but still only a very small percentage of the
lines we place. We're pretty good at doing an early assessment of patient's
venous access needs, and when that assessment is done soon after the patient
hits the hospital a midline can become a less viable option because
diagnostics may still need to be done. I really hesitate to put a midline
in a patient on whom we don't have a firm diagnosis and plan of care.
Alma Kooistra RN, CRNI
----Original Message Follows----
From: "Gwen Irwin" <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED]
Subject: Re: Midline guidelines from AVA roundtable
Date: Tue, 17 Oct 2006 19:50:35 -0500
Randy,
I hear you about midlines being a viable choice for venous access. I too
believe that midlines have a place in our assessment of the patient that
needs venous access. I have a midline study approved by our IRB, but am
unable to do the study, due to staffing and the manpower to complete it. I
have tried for 3 years to complete it without success. Currently, we are
not doing midlines. That doesn't change my mind that they are a viable
option.
I have to challenge you to provide all of us that don't use midlines to SHOW
US THE DATA! If you have thousands without complications, please share the
data. Please publish your outcomes. Don't defend their use, prove that
they are an option! Outcomes that you are supporting would be the change
factor of current INS standards about midlines.
I would love to see this information!
Gwen Irwin
Austin, Texas
----- Original Message ----- From: <[EMAIL PROTECTED]>
To: "Alma Kooistra" <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>;
<[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>
Sent: Saturday, October 14, 2006 6:32 PM
Subject: Re: Midline guidelines from AVA roundtable
BS and Poppycock...........................
Tired of you people that continually make those that use Midlines feel that
they are bad practitioners.
OK, Put your money where your mouths are........ Show us how many
Midlines you have placed.... How many you have had that have had
complications.... and then show us your PICC Stats as well. Show us. I
have seen thousands of Midlines go a month without complication. Give me a
reason to cross over!!!
Give me a reason to stop defending their use!!!!! And give me your
proof.....
Not some article based on Bias. An article not written by someone
associated with a particular Company such as Navigator or Sherlock that
wants every line placed to be a PICC so that they hawk their wares. Show
me!!!!!!!
Show me your Data!!!!! And I will stop arguing for Midlines. I know the
Standards so please don't send me those.
You everloving Lightning rod.
Randy
PS. Alma sorry that it was your email responded too. No offense to you.
--
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: "Alma Kooistra" <[EMAIL PROTECTED]>
We generally refrain from placing a midline in anyone who has a potential
of
>1 week of IV therapy, no matter how benign the infusate. Personally, I
think that anyone sick enough to need access >1 week probably should have
a
PICC. That's pretty 'out there' I know, and that philosophy is not
written
in policy at my facility. I just think it makes good sense, and since I
insert nearly all of the lines it's pretty easy to enforce.
Alma Kooistra RN, CRNI
----Original Message Follows----
From: [EMAIL PROTECTED]
To: [EMAIL PROTECTED], [EMAIL PROTECTED], [EMAIL PROTECTED]
Subject: Re: Midline guidelines from AVA roundtable
Date: Sat, 14 Oct 2006 12:31:44 -0400
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
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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