A couple of questions for those inserting midlines without ultrasound:
1. Are you using MST or just the peel-away shielded introducer?
2. Are you using maximum sterile barrier precautions?
Thank you,
Daphne Broadhurst
Desjardins Pharmacy
Ottawa Canada
Daphne,
We use Ultrasound on many patients who receive ML IV catheters, however, for the nurses on our team who aren't yet proficient with its use, we place them either using the tradiotinal method or using MST. So, a 14 or 16 gauge introducer is placed, depending on whether it is a 3 or 4 french; and this method is used if the patient has excellent venous access, or like the one I had the other day, who was so confused, my goal was to get it in quick, using the least amount of steps. But MST is also used and we like the 22g Introcan peripheral IV catheters to do the intial cannulation, and then we place the appropriate MST wire and dilator.
So, in general:
US on approx 75%.
MST on approx 20%.
Traditional method is used approx 5% of the time.
And yes, our policy calls for all to have Maximum Barrier Precautions.