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.
* 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 
* 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...