Midlines

Overview

Length: 8-25 cm, inserted through upper arm veins, terminates at axilla.
- Shorter ones last better than ultrasound guided peripheral IVs.
- Longer ones can run pressors. [1] and has less complications than central lines.
Because they terminate at axilla, are peripheral access, not a central venous catheter.

Indications

Unable to establish standard peripheral IV
Concern for IV dislodging
Longer term IV access

Contraindications

Equipment Needed

Procedure

Complications

Usage

Medications that cannot be run through midlines:
- Chemotherapy
- Total parenteral nutrition
Length of use: typically 2-7 days, but institution dependent

See Also

External Links

Scott Weingart. EMCrit 262 – Midlines – Part 1. EMCrit Blog. Published on December 27, 2019. Accessed on December 28th 2019. Available at https://emcrit.org/emcrit/midlines-1/
Short and extended videos of 20 cm midline placement

References

The Utility of Midline Intravenous Catheters in Critically Ill Emergency Department Patients Spiegel, Rory J. et al. Annals of Emergency Medicine, Volume 0, Issue 0 https://www.annemergmed.com/article/S0196-0644(19)31236-3/fulltext

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