Making a picc line a Midline

picclineman · Dec 20, 2010

In the 15 years i have done PICCs and midlines, i have used PICC catheters and trim them to become midlines per INS definition. The PICC catheters are trimable catheters , so i do not see any reason why not. Of course, your rep is going to tell you not to trim their PICC catheters because they need to have more sales... Except if you use a groshong double lumen you cannot trim the catehter. If there is any research out their, i have not encountered any. How are my patients, i have had no adverse report so far. I know, once i had a discussion with another nurse who told me that i should not be trimming the PICC catheter becase she says her rep told her to order midline catheters. She told me that the label of the PICC catheter says PICC Not midlines and this will cause nurses to mistakenly use the line for a vesicant. I said then the nurses should make sure they look at at the kardex or the nurses notes of the person doing the procedure for the tip position or better yet, look at the chest xray film..

picclineman · Dec 20, 2010

Has anyone taken the Vascular Access, Board Certification exam? Were the questions really for a board certified vascular access professional?

iluvivt, BSN, RN · Dec 21, 2010

NO ....from a legal and clinical standpoint this is a BAD idea. First many PICCs are now power injectable and labeled on the tails,clamps or external portions of the catheter and you should not power inject through a midline catheter...but there it would be clearly labeled as a PICC and capable of power injection upon assessment. That is the PROBLEM..it is labled as a PICC and if cut to midline it can be used as if it had a central tip location. So if you trim a PICC to be a midline and it is inadvertantly used for anything out of the ph range between 5 and 9 or osmolarity greater than 500 mOsm..and a bad outcome occurs....YES they will come back to the insertor of the IV device and ask YOU to explain