Welcome to nursing care of midlines. A midline catheter is a peripheral vascular access device that provides intermediate-term venous access. It is inserted into a peripheral vein and advanced to the axillary or subclavian vein, with a length of eight to twenty centimeters and can remain in place for one to four weeks.
Proper insertion site care and assessment are crucial for midline maintenance. Nurses must perform daily assessments, inspecting the site for signs of complications such as redness, swelling, warmth, pain, or drainage. The site should be kept clean and dry using aseptic technique, while avoiding unnecessary manipulation of the catheter.
Dressing changes and flushing are essential components of midline care. Dressings should be changed every five to seven days using sterile technique and chlorhexidine for site cleaning. Flushing with normal saline before and after medication administration, and every eight to twelve hours when not in use, maintains catheter patency using a pulsatile technique.
Continuous monitoring for complications is critical in midline care. Nurses must watch for local complications including phlebitis, infiltration, occlusion, infection, and thrombosis. Key monitoring signs include pain, redness along the vein track, swelling, resistance to flushing, and systemic symptoms like fever that may indicate serious complications requiring immediate intervention.
To summarize midline nursing care: These devices provide intermediate-term access for one to four weeks. Essential care includes daily site assessment, sterile dressing changes, regular saline flushing, continuous monitoring for complications, and thorough patient education for optimal outcomes and safety.