pic line or mid line

Jenneu · Jul 9, 2005

which is supposed to sit in the right atrium. A midline is just a longer peripheral - a few inches longer than a regular peri IV. They can stay in place longer than the 3-5 days that a peri. can stay in place. Also a PICC can remain in place indefinately as long as it is well cared for and no infection develops. The facility where I work started using triple lumen PICC lines - and they are great especially when you have patients on multiple antibiotics, antifungals, antivirals, needing packed red cells AND chemo in the same day!

Hope this clears it up. I've never seen or used a midline - anyone else?

J

could someone please explain the difference between a pic line and mid line, or is there no difference?

fp nurse · Jul 9, 2005

which is supposed to sit in the right atrium. A midline is just a longer peripheral - a few inches longer than a regular peri IV. They can stay in place longer than the 3-5 days that a peri. can stay in place. Also a PICC can remain in place indefinately as long as it is well cared for and no infection develops. The facility where I work started using triple lumen PICC lines - and they are great especially when you have patients on multiple antibiotics, antifungals, antivirals, needing packed red cells AND chemo in the same day!
Hope this clears it up. I've never seen or used a midline - anyone else?
J

Thanks Jenneu, This is why i ask- We had a pt that had an infected mid line. The home health agency would not pull it. They said their RN's were not certified. I called the e.r. to see if they could pull it. The nurse i spoke with (who was very nasty) told me that it WAS NOTa mid line there was no such thing as a midline ,and that it was a picc line. A picc line could be placed anywhere on the body arms ,legs ,and no they dont do that there. I thought I was using the wrong terminology. It was a mid line.

PeachyOrthoRN, RN · Jul 9, 2005

We don't use midlines anymore, they figure just put a PICC line in anyway. They are longer lasting and they gt infected less frequently I see if they are taken care of and they clot less again if taken care of. Sounds like what you had to me was a midline. :)

AZ_Ogre · Jul 9, 2005

We don't use midlines anymore, they figure just put a PICC line in anyway. They are longer lasting and they gt infected less frequently I see if they are taken care of and they clot less again if taken care of. Sounds like what you had to me was a midline. :)

We use midlines at my hospital. Mainly used for patients with poor access that are expected to stay for a long period of time and require IV meds. The advantage of a midline is, in this hospital anyway, that you are not required to have a doctor's order to insert and it doesn't require a x-ray to check placement but can stay in much longer.

CritterLover, BSN, RN · Jul 10, 2005

i place both piccs and midlines. in order to be a central line (picc), the tip of the catheter must be in a central vessel -- either the superior vena cava or the inferior vena cava (the tip could also be in the right atrium as one poster mentioned, but most facilities avoid this due to the potential -- though slight -- to trigger a fib if the tip is flopping around in the right atrium).

technically, if the tip is not in the central vessel, then the catheter is a midline.

in general, i do not start out intending to place a midline. sometimes, though, i am unable to thread the catheter beyond a certain point (usually the shoulder joint, sometimes it hits the clavicle and won't go further). also, sometimes the catheter heads "up" instead of "down," going into the ij instead of the svc. if this isn't "fixed" after pulling back and reinserting a few times, i will often give up and just pull the catheter back and leave it subclavian. and of course, there are times when i just don't measure correctly to determine the lenghth, and the catheter ends up short. if the patient doesn't require central access (such as tpn), a midline will usually suffice.

the only time i have intentionally placed midlines is when there is no doctor to read the chest xray (such as late evening when there is an uncooperative er doctor). in this situation, there are a few times where i have placed a midline to avoid the need for a chest xray. i should caution, however, that some midlines do need to be xrayed. if they go in far enough that they could be heading "up" into the neck veins, or if there is any difficulty in removing the stylet, they need to be xrayed for positioning (i have actually seen piccs go up the arm, hit the shoulder, make a u turn heading back down the arm, hit the radius and turn again, going back up the arm).

accoring to infusion nurse society standards, a midline is good for 2-4 weeks. a picc is good for up to 1 year.

hope this is clear -- i'm a little sleep deprived right now.