Midline Catheter Placement And Care
A midline catheter is used for medications or fluids that do not irritate veins. Midlines are usually put into a vein in the arm. A midline catheter lasts longer than a regular IV line, but not as long as a PICC. Midlines are often inserted when good veins for regular IVs are not available or IV medication or fluid is required for an extended period of time.
A midline is a vascular access device approximately 8-10cm in length. The cephalic, basilic or brachial vein is accessed using ultrasound guidance, with the catheter tip residing at or below the level of the axilla. The dwell time is up to 30 days.
A midline should be considered for a short-term course of medications and solutions such as antibiotics, fluid replacement, and analgesics which are normally tolerated well by peripheral veins.
Do not use midline catheters for continuous vesicant therapy, parenteral nutrition, or infusates with an osmolarity greater than 900 mOsm/L. If unsure consult a Pharmacist.
Avoid the use of a midline catheter when the patient has a history of thrombosis, hypercoagulability, decreased venous flow to the extremities, or end-stage renal disease requiring vein preservation.
How Is A Midline Catheter Inserted?
A midline is inserted in the hospital, clinic at a time to suit you and your clinical team. A midline is inserted using a clean technique and ultrasound guidance.
The Infusion Healthcare RN will use an ultrasound machine to examine your arm and visualise your veins. A decision will be made by the RN as to which arm and vein to use.
The procedure is an aseptic technique which helps reduce microbes and the risk of infection. Your arm is cleansed with antiseptic prior to cannulating the vein. Local anaesthetic is used at the site to numb the area where the needle is inserted. Once this has taken effect, the remainder of the procedure should be relatively pain free and comfortable.
The midline is then secured and covered with a sterile, transparent dressing. The catheter is now ready for immediate use.