- 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.  and has less complications than central lines.
- Because they terminate at axilla, are peripheral access, not a central venous catheter.
- Unable to establish standard peripheral IV
- Concern for IV dislodging
- Longer term IV access
- Overlying skin infection
- Thrombosis of target vessel
- Arterial puncture
- One observational study of 403 ED patients showed no catheter-associated bloodstream infections
- Medications that cannot be run through midlines:
- Total parenteral nutrition
- Length of use: typically 2-7 days, but institution dependent
- Central venous catheterization
- Rapid infusion catheter (RIC)
- Intraosseous access
- Venous cutdown
- Umbilical vein catheterization
- Ultrasound assisted peripheral line placement
- External jugular vein cannulation
- The "Easy IJ"
- 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
- 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