EMCrit 262 – Midlines – Part 1 - a podcast by Scott D. Weingart, MD FCCM
from 2019-12-27T23:06:30
Today on the podcast, we discuss Midlines. This is the first of two parts. In a week, I will interview Rory Spiegel on the topic, so send me your thoughts and questions in anticipation of that episode.
Our Article
* Utility of Midlines in Ann Emerg Med 2020
What the Heck is a Midline?
a 8-25 cm catheter that is placed in the arm and doesn't extend past the shoulder
Why Ultrasound-Guided IVs Suck?
* They aren't long enough [30021833]
* Nearly 1/2 of them are dislodged in 24 hrs [Ann Emerg Med 1999;34(6):711]
* Another study demonstrating they do not last [AJEM 2010;28:1]
* Vessel Depth and Catheter Depth are the key to longevity [AJEM 2011 Fields et al.]
* Need 2.75 cm in the vessel for good reliability [https://doi.org/10.1016/j.annemergmed.2019.11.013]
* Midlines are better for avoidance of infections
Which Midlines Do We Use?
10 cm Midline
Bard Powerglide ST
20 cm Midline
Medcomp 20 cm 5F CT Midline
I take no money from any of these folks
Video of the Dual-Lumen Midline Placement
Start at 7:10
Other Lit
Safety of Midlines for
Send Me ?s below or on Twitter
Now on to the Podcast...
Further episodes of EMCrit Podcast
Further podcasts by Scott D. Weingart, MD FCCM
Website of Scott D. Weingart, MD FCCM