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Pre‐procedural considerations

Equipment

Silicone and polyurethane are the materials most frequently used in the manufacturing of midline catheters (de Lutio [109], Hadaway [194], Kupensky [254]). Catheters are available as single and dual lumen in lengths of up to 20 cm, which can be cut to the desired length following measurement of the arm from the selected vein towards the axilla. They are available in various sizes from 2 to 5 Fr (French; a larger Fr indicates a larger internal catheter diameter) (Dougherty [124], Hadaway [194]). Newer all‐in‐one midline catheters come in a set measure of either 8 or 10 cm and they are available in 4 or 5 Fr (Moureau and Chopra [330]).
Procedure guideline 17.6

Midline catheter insertion

Table 17.4  Prevention and resolution (Procedure guideline 17.6)
ProblemCausePreventionAction
Missed vein: see ‘Missing the vein on insertion of the cannula’ in Problem‐solving table 17.3
Unable to advance catheter
Valves
Choice of vein, for example the cephalic narrows above the antecubital fossa
Select a vein with fewer valves or one with a large lumen.
Flush and attempt to advance the catheter.
Depending on the length advanced, it may be acceptable to leave it and use it for a short period of time.
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