[mandykal]

what are the odds of infiltrating solumedrol 250cc/hr which was the total volume, in a 20GA mid line going into a basilic vein???

Midline was good for the first 45 minutes, then........can a line like that mirgrate out? Your response is greatly appreciated.

[iluvivt]

of course it can happen..... infiltrations and extravasations can be difficult to detect with a midline nurses always look at the insertion site and sometimes foget to assess the upper third of the arm...... now a blood return is not an absolute guarantee...did you check foe one before infusing....did you assess the arm...how long had the line been in place....did you check for a phlebitis before you use...i suspect the line was not good from the start but it was not detected until enough infiltated for you to detect it...the basilic vein at that point(approx 20 cm from insertion site) is fairly deep ...generally a ml infiltration in the cephalic vein is easier to detect......remember never infuse a vesicant,tpn or any med that should it extravasate could cause tissue necrosis....not a big fan of midlines.....i would place them...leave my restriction and care list and then i would come back the next day to find it being used for dilantin dopamine etc.... the last several i have placed have been for pts going home to die anf they needed a stable line for an ms drip hope this helps