Midline catheters are a more secure peripheral alternative for patients who require venous access for up to 30 days. Midlines are longer peripheral IVs inserted by an interventional radiologist under ultrasound guidance and can be used for blood draws, medications, and intravenous fluids. TPN, vasopressors, and chemotherapeutics are generally not used with a midline.
Benefits of a midline:
- A midline is a secure peripheral IV that can stay in place up to 30 days. It is inserted similar to a PICC under ultrasound guidance and generally placed in the basilic vein.
- A midline can be used for blood draws, medications, and solutions. Midlines are generally not used for chemotherapeutics, vasopressors, and TPN.
- Midlines have low rates of complications including infection and catheter-associated thrombosis. NOTE: Midlines are not placed in the central circulation. An infection secondary to a midline is therefore NOT considered a reportable CLABSI (central line-associated bloodstream infection).
• Midlines are comfortable for the patient, easy to place with first time success, and cost effective.
How do I order a midline for my patient?
- Place procedure IR order in Epic: IR MIDLINE CATHETER INSERTION [IMG11486]. See image below.
- IR is available for midline placement M-F from 8 AM-5 PM.
- IR will be evaluating every order for a PICC to see if the patient would be a candidate for a midline instead. If a midline is indicated instead of a PICC, the radiologist will contact the ordering provider directly.
- Midlines are removed similar to a PICC. The patient does not need to return to IR for removal.
Click image to enlarge.