Midlines

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

Equipment Needed

Procedure

Complications

Usage

  • Medications that cannot be run through midlines:
    • Chemotherapy
    • Total parenteral nutrition
  • Length of use: typically 2-7 days, but institution dependent

See Also

External Links


References

  1. 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