By Sue Carrington |

If you’re in the hospital and need to receive IV therapy for more than five days, or if your care providers are having trouble accessing your veins, they may recommend a midline catheter for receiving IV therapy. A midline might also be the best choice if you’re receiving care at home or in a long-term care facility, where immediate restarts of your IV are not an option.

What is a midline catheter?

The midline is a thin, soft, sterile rubber tube, typically eight inches long. Inserted through a needle placed into a vein in your arm, it lets your care team access your bloodstream to give you IV fluids, medications, blood products, or nutrition.

How is a midline catheter different from a peripheral IV?

A midline IV is inserted into a larger vein than the one used for a peripheral IV. As long as the midline is functioning properly and you don’t have complications, it can stay in your arm up to four weeks, compared with four days for a standard peripheral IV.*

What should I expect when the midline is put in?  

The midline is placed by a specially trained nurse during a sterile procedure. The IV goes through a needle into a vein near the bend of your arm. Then, it’s threaded to just under your armpit. The procedure takes about 45 minutes and requires you to lie still.

Will I feel any pain or discomfort?

You may feel a slight sting when the needle is inserted, but after that, the midline should not be uncomfortable. You may see a small red bump where the midline enters your arm, but this is a normal reaction. You shouldn’t have any pain, swelling or drainage as you receive the IV.

What are the benefits?

It offers the option of uninterrupted IV therapy throughout your stay at the hospital. And, you won’t be stuck multiple times to restart your IV treatment.

What are the risks?

The most common complication associated with midline use is phlebitis, or an inflamed vein. This happens when the catheter irritates the vein lining as it’s put into the vein. Another potential risk is thrombosis, or vein clotting.

If either complication is observed, expect your medical team to stop the infusion and remove the midline at the first sign of redness or pain. Depending on the length of remaining IV therapy, the most appropriate vascular access device will be selected for the patient.

What should I look out for?

Make sure your insertion site is clean and dry at all times. Check your site each day for any sign of swelling, redness, drainage, or tenderness. Tell your nurse immediately if you notice any of these signs.

*This may differ from hospital to hospital depending on their protocol.

 

 

References:

Bridging the IV access gap with midline catheters – https://www.rch.org.au/uploadedFiles/Main/Content/anaes/bridging_the_IV_access_gap_with_midline_catheters.pdf

Midline IV Catheter Patient Education – http://www.ambrosiahc.com/wp-content/themes/ambrosiahealthcare/pdf/pat_midline_instr.pdf

When to use a midline catheter – https://journals.lww.com/nursing/Citation/2005/04000/When_to_use_a_midline_catheter.49.aspx

Guidelines for the Prevention of Intravascular Catheter-Related Infections – https://www.cdc.gov/hai/pdfs/bsi-guidelines-2011.pdf

Midline Catheters: An Essential Tool in CLABSI Reduction 5 – http://www.infectioncontroltoday.com/articles/2013/03/midline-catheters-an-essential-tool-in-clabsi-reduction.aspx

Complications of Peripheral IV Therapy – https://www.nursingcenter.com/ncblog/february-2015-(1)/complications-of-peripheral-i-v-therapy

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