Midline Catheter

A midline catheter is a thin soft tube that provides access to peripheral veins for infused medications or fluids. It is placed in an upper arm vein and the tip of the midline catheter ends near the axilla (near the armpit).

Why do I need a midline?

A midline catheter is a peripheral catheter that can remain in use longer than a traditional peripheral IV catheter. Having a midline catheter prevents further vein injury due to frequent needle sticks for IV access.

Midline Placement

The midline placement procedure can be done in your patient room. The clinician will discuss the procedure with you. The process may be similar to the steps below:

• You will be covered with a sterile drape (sheet) to help reduce the risk of infection. Only the skin where the midline will be placed will be exposed and cleansed with an antiseptic.
• Ultrasound images will be used to help find the best vein to use.
• The site where the Midline will be placed may be numbed with an injection of local anesthetic.
• A needle is used to gain access to the vein and the catheter will be inserted into the vein.
• The catheter will be flushed with saline solution and a securement device and dressing will be placed over the insertion site.

Risks and Complications

• Infection
• Bleeding
• Injury to vein or lymph ducts near vein
• Clots or air bubbles in the bloodstream, clots can travel to lungs (pulmonary embolism)
• Blockage of vein due to catheter
• Pain, swelling or soreness in arm with catheter
• Nerve injury
• Accidental arterial access
• Catheter incorrectly positioned or moves out of correct position

Protecting your Midline at Home:

Prevent Infection

• Use good hand hygiene.
• Only touch catheter if you need to.
• Only touch catheter after washing your hands.
• Encourage all visitors to use good hand hygiene as well.
• Keep your catheter and dressing dry. No bathing or swimming. Cover catheter with shower glove or plastic wrap as described by your health care provider/home care agency when showering.
• If dressing gets wet, call your healthcare provider/home care agency.

Avoid Damage to Catheter

• Do not use sharp objects or scissors around your catheter that could cut or put a hole in it.
• Do not let anything pull or rub on catheter including clothes, children or pets.
• Look out for signs of damage, cracks, leaks or catheter pulling out.

Prevent Blood Clots

• Use the arm as much as possible in your normal daily activities. This improves circulation.
• Avoid activities that require excessive use of your arm (sports, carpentry, etc) unless approved by your provider.
• Avoid activities that cause pain in your arm.
• Do not lift anything over 10 lbs with affected arm.
• Stay hydrated.

References:
Krames: PICC, Krames: Discharge Instructions: Caring for your Peripherally Inserted Central Catheter (PICC), Bard Access Systems: PowerMidline Catheter Patient Guide