To improve practice of avoiding using a picc line for a midline, is it possible to rewire and insert an actual midline to the already existing picc line in place? for example, you tried to place a picc but it wouldn't thread so you back it down to a midline and the physician is good with a midline, instead of leaving the actual "picc" line product in place can it be rewired and use an actual midline catheter so there is no mistake in identifying what it is?
thanks,
Brook Grzadzinski, MA, BSN, RN
This would be an acceptable method as long as a midline is appropriate for the therapy based on the parameters listed in the INS standards of practice - pH, osmolority, vesicants. This is determined by the infusion/VA specialist in collaboration with pharmacy. Most physicains have not idea about these factors so I would never rely on what they say is acceptable. Correct midline tip location as defined by INS standards and strict attention to aseptic technique with a new sterile fleld, etc. This is better than leaving excessive amount of PICC outside. My only question is if the therapy is acceptable for a midline, then why was a PICC being inserted in the first place? Longer catheters expose the patient to greater risk. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
thanks, i see your concern about needing the picc in the first place. If pt's are on antibiotics longer than expected, or the midline use will by us time until another decision is made regarding access (of course infusing only appropriate infusates through it), or no other IV access is available. it doesnt happen that often but it doesnt sit well with me when there is an "actual picc line" that is functioning as a peripheral, there seems to be room for air when just looking at the line.