The phlebotomy team is unable to obtain labs despite multiple attempts. The patient has a midline in place but the vascular access team is unable to aspirate blood using either vacutainer or syringe method. What do you think about the practice of applying a tourniquet to the upper arm of an extremity with a midline in place to obtain labs from the midline?
That would depend on where the tip is actually located. Recently I did a Google search looking for images of "Midline tip location". I was surprised to see so many drawings of the wrong location. If the tip is level with the axilla or armpit and does not go any farther into the shoulder area, a tourniquet might work. But there still could be no space left between the catheter tip and the tourniquet location. This would prohibit blood return and could damage the vein wall from the presence of the catheter. Have you focused on withdrawal technique including - a very slow gentle aspiration of the syringe, and switching to a smaller syringe such as a 3 or 5 mL. Those techniques might work. If not, I would say the midline is not functioning correctly, the same as what I would say for any other VAD not yielding a blood return. Lynn
PS - there are no studies on using a midline of any kind for obtaining blood samples.
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