6
NOTE:
(Pediatric) Midline catheters are peripheral infusion devices with the tips terminated
in either the basilic, cephalic, or brachial vein, distal to the shoulder. The basilic vein is pre-
ferred due to vein diameter. The tip does not enter the central vasculature. Additional site
selections include veins in the leg with the tip below the groin and in the scalp with tip in the
neck, above the thorax (EJV) [INS, 2016].
NOTE:
(Pediatric) Prep the insertion site and surrounding skin per facility policies, proce-
dures, and/ or practice guidelines. Use chlorhexidine with caution in premature infants and
for infants under 2 months of age due to risks of skin irritation and chemical burns [INS,
2016]. Povidone Iodine should be removed from the skin after the procedure to prevent
tissue damage, absorption, and thyroid suppression. [NANN, 2007]
NOTE:
(Pediatric) When infusion volume is a concern in small or pediatric patients, flush
with 3 mL per lumen or per facility guidelines.
Possible Complications
The potential exists for serious complications including the following:
• Air Embolism
• Bleeding
• Catheter Erosion Through the Skin
• Catheter Embolism
• Catheter Occlusion
• Catheter Related Sepsis
• Exit Site Infection
• Exit Site Necrosis
• Extravasations
• Fibrin Sheath Formation
• Hematoma
• Heparin Induced Thrombocytopenia
• Hypersensitivity, anaphylactic or
anaphylactic-like reaction during placement
1
,
positioning, flushing of catheter or cleaning of
catheter exit site.
Insertion Instructions
Prior to beginning placement procedure, do the following:
•
Examine the package carefully before opening to confirm its integrity and that the expi
-
ration date has not passed. The device is supplied in a sterile package and is non-py-
rogenic. Do not use if package is damaged, opened or the expiration date has passed.
Sterilized using ethylene oxide. Do not re-sterilize.
• Inspect kit for inclusion of all components.
WARNING:
Do not use the catheter if there is any evidence of mechanical damage or
leaking. Damage to the catheter may lead to rupture, fragmentation, possible embolism,
and surgical removal.
• Intolerance Reaction to Implanted Device
Laceration of Vessels or Viscus
• Perforation of Vessels or Viscus
• Phlebitis
• Spontaneous Catheter Tip Malposition
or Retraction
• Thromboembolism
• Venous Thrombosis
• Vessel Erosion
• Risks Normally Associated with Local or
General Anesthesia, Surgery, and
Post-Operative Recovery
