--Midlines measure 3-8 inches.
--They are peripheral catheters, not central, do not require x-ray
--Used for <30 days (short-term)
--May be used for blood draws
--when duration of therapy likely to >6days, use midline or PICC
--less than half infection rate of PICCs
AVERAGE DWELL TIMES:
PICC- 393 hours
Midline- 283 hours
PIV- 44 hours
Rates of infection:
highest-
non-tunneled
arterial
tunneledCVC
PICC
PIV
Midline
Implanted port
lowest
Midline:
--use for infusions appropriate for peripheral infusions
--does not require confirmation of terminal tip (x-ray)
--NOT appropriate fo rinfusions with osmolarity >600mOsm/L, or for TPN
--can be used for UP TO 29 days
--blood draws okay
--rate of occlusion 1.9-29%
PICC
--lower 1/3 of SVC (central)
--requires x-ray or EKG
--can be used for ALL infusions
--no limit on dwell time
--blood draw okay
-- rate of occlusion 25-33%
Per INS, meds appropriate for peripheral infusion have pH of 5-9
(Normal saline pH is 4.5) ??
No CDC standards
No "continuous vesicant medications and solutions"
same reimbursement code as PICC, with lower insertion costs
Deep veins of the upper arm have 5x the flow rate of the hand/forearm, which provides greater hemodilution
A vein should be 3x size of selected catheter
phlebogenic=causing phlebitis (inflammation of the vein wall)
