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The Midline Catheter: A Clinical Review
Daniel Z Adams1, Andrew Little2, Charles Vinsant1
1Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
The Journal of Emergency Medicine
|July 12, 2016
Summary
Midline catheters (MC) offer a safe and cost-effective alternative for venous access in the emergency department (ED), demonstrating low infection rates comparable to peripheral IVs and longer dwell times than standard catheters.
Area of Science:
- Emergency Medicine
- Vascular Access Devices
- Infection Control
Background:
- Venous access is a frequent and critical procedure in the emergency department (ED).
- Device selection depends on patient status, laboratory needs, and therapeutic requirements.
- Ultrasound guidance and trained personnel can improve technically difficult placements.
Purpose of the Study:
- To compare indications and complications of various venous access devices.
- To highlight midline catheters (MC) as a safe and cost-effective option for ED venous access.
Main Methods:
- Comparison of complication rates and dwell times for different venous access devices.
- Analysis of cost-effectiveness and insertion techniques for MCs.
Main Results:
- Midline catheters (MC) show bloodstream infection rates comparable to peripheral IVs (PIV) but significantly lower than PICCs and CVCs.
- MC dwell times (7.69-16.4 days) exceed PIVs (2.9-4.1 days) and are similar to PICCs (7.3-16.6 days).
- MC insertion cost is comparable to three PIVs, offering cost savings when avoiding central lines or for difficult peripheral access.
Conclusions:
- Midline catheters are versatile, with low complication rates, long dwell times, and high first-attempt success.
- Utilizing MCs in the ED for prolonged hospitalizations or difficult peripheral access can reduce patient costs and risks.
