Midline Catheters: Past, Present and Future
Midline catheters are multi-faceted devices that offer the potential for reduced complication rates compared to other vascular access options. Midline catheters may be appropriate for venous access in patients who:
- Need prolonged IV therapy
- Have challenging vascular anatomy due to age or medical history
Recent dynamics in the healthcare industry have fueled a resurgence in their utilization. This Wednesday Workshop series, presented by Mary Smith and Edward Korycka, reviews the history, current practice, and new innovations in midline catheter technology.
Mary Smith, RN, VA-BC is committed to improving patient experiences and has been a leading voice in vascular access education for over 20 years. Smith speaks locally, regionally, and internationally on best practices and is the founder of CVC Health Care, which since 2012 has grown into the largest independent provider of vascular access education in the world. It is notable that the vascular access team she started and led at her local hospital in Wisconsin went 14 years without any recorded catheter line-associated bloodstream infections (CLABSIs).
Edward Korycka, RN, has nearly 30 years of nursing experience with 20 years spent specializing in vascular access. He is an active member of the Association for Vascular Access and the Infusion Nurse Society, having served in various leadership positions. In his current role at Access Vascular, Korycka strives to improve patient outcomes by promoting training and support for the company’s novel vascular access device offerings.
Session 1: Looking Back
“Looking Back” dives into the history and evolution of midline catheters, including indications for use, risks and cautions, and ways to reduce complication rates.
Midline catheters were first used in 1950 and were placed solely by physicians until 1960. Before ultrasound guidance became common practice for insertion, blind sticking techniques were used for placement.
Midline catheter indications:
- To administer medications and solutions such as antimicrobials, fluid replacement, and analgesics with characteristics that are well-tolerated by peripheral veins
For more information about midline catheter cautions and reducing complications, view the full session below.
Session 2: Current Practice
Session 2 reviews dwell times, clinically indicated device removal, site and size selection, insertion techniques and tip location. Standards and recommendations are discussed, focusing on the importance of targeted education and surveillance strategies in vascular access.
Midline catheters are the fastest growing vascular access device on the market. However, appropriate midline catheter uses and contraindications are not widely known in the healthcare industry. It is imperative healthcare professionals working with these devices receive training and education on insertion, maintenance, and removal. Personnel that may insert midline catheters include:
- VAT, VAST, RNs, RTs, PAs, APNPs, Hospitalists, MDs
All vascular access insertion should be guided by ultrasound. Insertion techniques include the Modified Seldinger (MST) and Accelerated Seldinger (AST).
Some complications associated with midline catheters include:
- Catheter Associated Deep Vein Thrombosis (CA-DVT)
- Catheter Associated Blood Stream Infection (CA-BSI)
For more information, watch the full session below.
Session 3: New Innovations
Session 3 focuses on advanced technology that helps to reduce the risk of complications such as catheter occlusion and thrombotic events. In this session, Mary Smith and Edward Korycka discuss additional insights about the future of midline catheters.
Midline complications related to thrombosis have negative impacts on patient quality of care and hospital costs. The root causes of the thrombosis cascade when related to midline catheters are polyurethane-based materials and coatings that attract platelets. Advanced catheter technology, such as hydrophilic biomaterial, can improve outcomes.
To learn more, view the full workshop session below.
Eloquest Healthcare is committed to providing important, timely information to help you optimize patient outcomes during vascular access procedures and maintenance. To learn more about the history, current practice, and new innovations in midline catheter technology watch full the workshop series!