24 min

EMCrit 262 – Midlines – Part 1 EMCrit Podcast - Critical Care and Resuscitation

    • Medicine

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

The Hospitalist & the Resuscitationist 2020

Phillipe Rola and a panoply of rogues will be discussing amazing things in beautiful Montreal



May 20-22, 2020



* See the Poster

* Check out the Conference



Send Me ?s below or on Twitter

Now on to the Podcast...

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

The Hospitalist & the Resuscitationist 2020

Phillipe Rola and a panoply of rogues will be discussing amazing things in beautiful Montreal



May 20-22, 2020



* See the Poster

* Check out the Conference



Send Me ?s below or on Twitter

Now on to the Podcast...

24 min

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