Help!! I'm am working on making an algorithm for vascular access selection.

When to place PICCs or midline in relation to medications and length of stay.

I've looked online for examples but I haven't found what I'm looking for. Anyone have any examples or guideline of how to get started? I'm completely lost!!

First you must assess your policy for your institution for catheter dwell times. If a short term, less than 3 inch IV catheter can stay in for 96hrs, then four days of IV therapy may well be able to accommodate the medication for that time frame.

However, INS standards also need to be assessed.

Recommended dwell for a Midline is 2-4 weeks, whereas there is NO recommended dwell time for a PICC. And, since a midline is really just a long peripheral IV catheter, considerations must be made for the pH and osmolarity of the solution/medication.

And since a PICC is one type of central line, all medications can be given through it.

However, for a short term peripheral, it is ideal, to have the osmolarity of the medication to be less than 600, and the pH between 5 and 9.

Solutions/medications outside of these parameters may be too harsh as one does not have the blood flow in your arms that you do in the central vascular system.

Thanks! I have all that in bullet format per our hospital and INS.

I guess I should call it an algorithm map? I have made up a few I just don't like them and they look unorganized to me.

I do not have it but I know Bard has a whole algorithm form. I would talk to your Bard rep or email the website, I am sure they would send it out to you.