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Midline catheters look like PICC lines, but they are shorter and don't remain in place longer than six weeks. Chemo can be hard on your veins, which can become fragile, hard to find, and difficult to access with a needle. Having a midline catheter within your vein can give you extra protection during chemotherapy infusions. A midline catheter must be kept clean and should be maintained on a regular schedule. Learn the essential facts about midline catheters here.
Midline Catheter Basics
A midline catheter is a vascular access device (VAD) used for chemotherapy. Midline catheters are used when you need treatment for one to six weeks. These devices consist of a length of catheter inside your upper arm and an extension line outside your arm, which terminates in an end cap or a branching hub of multiple-access catheters. You won't be stuck with an IV needle for treatments, because your infusion nurse will use the midline catheter extension to give chemo drugs or other fluids.
No Surgery Needed for Midline Catheter Placement
A midline catheter is placed into an upper arm vein and reaches from your elbow almost to your armpit. A trained nurse can place the catheter without any need for general anesthesia. Midline catheter placement may be done in a clinic or a hospital room.
Compare Midline Catheters to PICC Lines and Mid-Clavicular Catheters
Unlike an implanted port, a midline catheter does not extend all the way to your heart. That is why it's called midline – these catheters don't provide access to a central heart vein – these catheters go about midway to your heart. A PICC line and an implanted central venous access port have catheters that go all the way to your heart. A mid-clavicular catheter goes from your inner elbow to about the middle of your collarbone, or clavicle.
Also Known As
Long-line, halfway, midline, extended peripheral, and Peripherally Inserted Catheter (PIC)
Midline Catheter Uses
Your midline catheter can be used for several types of intravenous therapy. It can accommodate chemotherapy, saline for rehydration, sedatives, antibiotics, and blood transfusions. Some clinics will not use a midline catheter to take a blood draw for your complete blood count.
Care and Comfort with Your Midline Catheter
You will need to keep your catheter insertion point clean and dry to prevent infections. Always wash your hands before touching or caring for the catheter. Ask your nurse for instructions about taking care of the dressing and flushing of the catheter line. Be sure that you or someone who will help you can keep the area sterile when changing the dressing. Have all supplies on hand before you clean your midline catheter.
Precautions to Take with Your Midline Catheter
Do not have blood pressure measurements done on your catheter arm. Don't lift more than 10 pounds with your catheter arm, to avoid straining the line or the dressing. Don't swim or take tub soaks while your midline catheter is in place. When you have a shower, do cover the external part of your midline catheter with plastic wrap or a bag, taped in place above and below the catheter. Protect your catheter's extension line from cuts and punctures. Do not pull on the extension line or rotate it in place.
When to Call For Help
It is normal for a little bleeding to occur around your catheter insertion point, but if it spreads wider than one inch, call for help. If the catheter appears to be longer or shorter than it was when you had it placed, call your clinic to have it examined. Infections can occur, so if you have fever, chills or swelling, report it to your doctor. You may need treatment for a blood infection – get help quickly. Sometimes a catheter or the extension gets blocked and won't flush easily. Don't force it, but do call for professional help.
Sources:
Chemotherapy Principles: An In-depth Discussion. What are the different ways to take chemotherapy? Types of central venous catheters (CVCs) or vascular access devices. American Cancer Society. Updated: 09/28/2010
The Royal Marsden Hospital Manual of Clinical Nursing Procedures, Chapter 44, pp. 605-607. Lisa Dougherty, Sara E. Lister. Wiley-Blackwell, 2004.