Forum topic

 To my knowledge, PowerGlide and PowerWand are the only 2 midline catheters with the labeled indication for power injection. Lynn

 Is it okay to power inject thru a midline?  I realize that the catheter may be able to withstand a power injection, but what about the peripheral vein?  What happens to the health of the vein?

We have done data collection on the BARD powerglide for over a year with approx. 150 placed at our facility. Most of the time we have placed them in the upper arms and a few have been in the lower arms. We do use them for power injections in Cat Scans and sometimes that is the only reason we place them, esp. in the ED. We have has a few complications, being clotting off and one phlebitis. No DVT's and no infections. Most of these catheters were used for 1 week or less but there were a few used up to 21 days. Would not rely on this catheter for lab draws, may only get 1-4 days of being able to get labs drawn of the line, though a continous IV fluids running through the catheter has a better chance of giving us lab draws longer. Part of our our ongoing assessment is that we see our patients everyday if we place the Powerglides and do arm circumference measurements as a baseline (The measureing tape is NOT iuncluded in the placement kits) at at every dressing change (measuring tape IS in the dressing kit) which is every 4 days at our facility because of the extension tubing partly under the dressing. Again , with this being in the upper arm we do not place these for ANY vesicant drugs, TPN, any form of chemotherapy. Powerglides are mostly being used for difficult access, antibiotics, blood products, hydration fluids, Heparin drips., or any thing that does not require Central venous access. We also do not let patients be discharged home with the Powerglides, because of frequent monitoring and most nurses in homecare have no knowledge of these cathetrs in our area

CT contrast IS a vesicant... no?   isn't that a contraindication for midline use or is it thought to be safe for a single injection instance. Repeated Vanco doses or amioderone gtt on the other hand phebenogetic. What about repeated CT injections, serial CTs?

 Contrast media is a vesicant due to its hyper-osmolarity, aka hypertonicity. Most all nonionic contrast agents have an osmolarity greater than 350 mOsm/L, the demarcation of isotonic and hypertonic. Many have an osmolarity greater than 600 mOsm/L, the INS criteria for what should not be infused through a peripheral vein. These catheters are labeled as midlines and therefore should be used in a manner suitable for midlines. Since we do not have published studies of outcomes with power injection through these new midlines, it is difficult to say how they should be used. pH of contrast media is all within the normal range of 6 to 8, so pH with contrast is not the problem. Lynn