Midlines: Difference between revisions
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==Overview== | |||
* 8-25 cm | *Length: 8-25 cm, inserted through upper arm veins, terminates at axilla. | ||
* Shorter ones | **Shorter ones last better than ultrasound guided peripheral IVs. | ||
* Longer ones | **Longer ones can run pressors. <ref>The Utility of Midline Intravenous Catheters in Critically Ill Emergency Department Patients Spiegel, Rory J. et al. Annals of Emergency Medicine, Volume 0, Issue 0 https://www.annemergmed.com/article/S0196-0644(19)31236-3/fulltext</ref> and has less complications than central lines. | ||
*Because they terminate at axilla, are peripheral access, not a [[central venous catheter]]. | |||
==== External Links | ==Indications== | ||
*Unable to establish standard peripheral IV | |||
*Concern for IV dislodging | |||
*Longer term IV access | |||
==Contraindications== | |||
*Overlying skin infection | |||
*Thrombosis of target vessel | |||
==Equipment Needed== | |||
==Procedure== | |||
==Complications== | |||
*Arterial puncture | |||
*One observational study of 403 ED patients showed no catheter-associated bloodstream infections | |||
==Usage== | |||
*Medications that cannot be run through midlines: | |||
**Chemotherapy | |||
**Total parenteral nutrition | |||
*Length of use: typically 2-7 days, but institution dependent | |||
==See Also== | |||
{{Vascular access types}} | |||
==External Links== | |||
* Scott Weingart. EMCrit 262 – Midlines – Part 1. EMCrit Blog. Published on December 27, 2019. Accessed on December 28th 2019. Available at https://emcrit.org/emcrit/midlines-1/ | * Scott Weingart. EMCrit 262 – Midlines – Part 1. EMCrit Blog. Published on December 27, 2019. Accessed on December 28th 2019. Available at https://emcrit.org/emcrit/midlines-1/ | ||
* [https://www.youtube.com/watch?v=lup5RyRvdlI Short] and [https://www.youtube.com/watch?v=gOV_K2PtJDk extended] videos of 20 cm midline placement | * [https://www.youtube.com/watch?v=lup5RyRvdlI Short] and [https://www.youtube.com/watch?v=gOV_K2PtJDk extended] videos of 20 cm midline placement | ||
* [http://www.emdocs.net/unlocking-common-ed-procedures-micropuncture-kits-for-difficult-vascular-access/ emDOCs: Micropuncture Kits for Difficult Vascular Access] | |||
==References== | |||
<references/> | |||
[[Category:Procedures]] | |||
Latest revision as of 03:23, 23 January 2021
Overview
- Length: 8-25 cm, inserted through upper arm veins, terminates at axilla.
- Shorter ones last better than ultrasound guided peripheral IVs.
- Longer ones can run pressors. [1] and has less complications than central lines.
- Because they terminate at axilla, are peripheral access, not a central venous catheter.
Indications
- Unable to establish standard peripheral IV
- Concern for IV dislodging
- Longer term IV access
Contraindications
- Overlying skin infection
- Thrombosis of target vessel
Equipment Needed
Procedure
Complications
- Arterial puncture
- One observational study of 403 ED patients showed no catheter-associated bloodstream infections
Usage
- Medications that cannot be run through midlines:
- Chemotherapy
- Total parenteral nutrition
- Length of use: typically 2-7 days, but institution dependent
See Also
Vascular access types
- Central venous catheterization
- Rapid infusion catheter
- Intraosseous access
- Venous cutdown
- Umbilical vein catheterization
- Ultrasound assisted peripheral line placement
- External jugular vein cannulation
- The "Easy IJ"
- Midlines
External Links
- Scott Weingart. EMCrit 262 – Midlines – Part 1. EMCrit Blog. Published on December 27, 2019. Accessed on December 28th 2019. Available at https://emcrit.org/emcrit/midlines-1/
- Short and extended videos of 20 cm midline placement
- emDOCs: Micropuncture Kits for Difficult Vascular Access
References
- ↑ The Utility of Midline Intravenous Catheters in Critically Ill Emergency Department Patients Spiegel, Rory J. et al. Annals of Emergency Medicine, Volume 0, Issue 0 https://www.annemergmed.com/article/S0196-0644(19)31236-3/fulltext