{"id":5000,"date":"2023-01-16T00:00:55","date_gmt":"2023-01-16T00:00:55","guid":{"rendered":"https:\/\/eu.bd.com\/iv-news\/?p=5000"},"modified":"2025-06-04T14:25:40","modified_gmt":"2025-06-04T12:25:40","slug":"are-midline-catheters-underused-in-the-emergency-department","status":"publish","type":"post","link":"https:\/\/eu.bd.com\/iv-news\/events-training\/are-midline-catheters-underused-in-the-emergency-department\/","title":{"rendered":"Are midline catheters underused in the emergency department?"},"content":{"rendered":"<p><span data-contrast=\"auto\">\u201cIn the ED [emergency department], time is chief,\u201d said Professor Baudolino Mussa, Vascular Access Surgeon and Professor of Vascular Access at the University of Turin in Italy.<\/span><sup><span data-contrast=\"auto\">1<\/span><\/sup><span data-contrast=\"auto\">\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Prof Mussa explained that oftentimes in the ED, the choice of vascular access device isn\u2019t always aligned with clinical recommendations due to the need for rapid decision-making.<\/span><sup><span data-contrast=\"auto\">1<\/span><\/sup><span data-contrast=\"auto\">\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">In fact, according to a study he conducted in the ED of the Cuneo Hospital, 95% of patients received peripheral catheters; however, after review, about 40% of these patients received the wrong device.<\/span><sup><span data-contrast=\"auto\">1 <\/span><\/sup><span data-contrast=\"auto\">This study is currently submitted for publication and will soon be publicly available.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">With this in mind, how do we make sure that patients are receiving the correct vascular access device, and the device itself is effective in their treatment?\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Dive into the conversation with Prof Mussa in his MACOVA 2022 presention: <\/span><b><span data-contrast=\"auto\">Midlines: A New Vascular Access Approach for Emergency Medicine.<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n\t\t\t\t\t<div class=\"gated_content\" id=\"gated_content-63c030d37bdba\">\n\t\t\t\t\t\t<div class=\"labelform notice-box margin-full\">\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<i class=\"fa fa-exclamation-triangle\" aria-hidden=\"true\"><\/i>\n\t\t\t\t\t\t\t\tBecome a VAMbassador to get access to the full article\t\t\t\t\t\t\t<\/p>\n\n\t\t\t\t\t\t\t<div class=\"loginwrapper\">\n\t\t\t\t\t\t\t\t<form name=\"loginform\" id=\"loginform\" method=\"post\">\n\n\t\t\t\t\t\t\t\t\t<p class=\"login-username\">\n\t\t\t\t\t\t\t\t\t\t<label for=\"user_login\"><\/label>\n\t\t\t\t\t\t\t\t\t\t<input required type=\"email\" name=\"log\" placeholder=\"Email address\" id=\"user_login\" class=\"input\" size=\"20\">\n\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"login-password\">\n\t\t\t\t\t\t\t\t\t\t<label for=\"user_pass\"><\/label>\n\t\t\t\t\t\t\t\t\t\t<input required type=\"password\" name=\"pwd\" placeholder=\"Password\" id=\"user_pass\" class=\"input\" size=\"20\">\n\t\t\t\t\t\t\t\t\t\t<i class='fa fa-eye showpwd'><\/i>\n\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t\t<p class=\"login-submit\">\n\t\t\t\t\t\t\t\t\t\t<input type=\"submit\" name=\"wp-submit\" id=\"wp-submit\" class=\"button button-primary\" value=\"Login\">\n\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/eu.bd.com\/iv-news\/events-training\/are-midline-catheters-underused-in-the-emergency-department\/#gated_content-63c030d37bdba\">\n\t\t\t\t\t\t\t\t\t<\/p>\n\n\t\t\t\t\t\t\t\t\t<div class=\"aa_error hide\">\n\t\t\t\t\t\t\t\t\t\t<p><\/p>\n\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t\t<\/form>\n\n\t\t\t\t\t\t\t\t<div class='extralink'>\n\t\t\t\t\t\t\t\t\t<a class=\"forgot\" href=\"https:\/\/eu.bd.com\/iv-news\/it\/password-persa\/\">\n\t\t\t\t\t\t\t\t\t\tForgot your password?\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<br \/>\n\t\t\t\t\t\t\t\t\t<a class=\"register\" href=\"https:\/\/eu.bd.com\/iv-news\/fr\/inscription\/\">\n\t\t\t\t\t\t\t\t\t\tNot registered yet? <strong> Sign up <\/strong>\n\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"content\" style=\"display:none;\">\n\t\t\t\t\t\t\t<h4><b><span data-contrast=\"auto\">What is a midline catheter?<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/h4>\n<p><span data-contrast=\"auto\">Midline catheters are typically 7.5 to 20 cm long and are inserted into the basilic or brachial vein of a patient\u2019s upper arm to enable peripheral infusion to larger blood vessels.<\/span><sup><span data-contrast=\"auto\">2<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><span data-contrast=\"auto\">Unlike peripherally-inserted central catheters (PICCs), midline catheters terminate in the peripheral and not the central vein.<\/span><sup><span data-contrast=\"auto\">3<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\"> \u00a0<\/span><span data-contrast=\"auto\">Midline catheters are designed to administer medication; however, they have been known to aid in blood draw for patients with difficult venous access (DVA) to avoid the need for multiple venipunctures.<\/span><sup><span data-contrast=\"auto\">4<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Learn more about midline catheters for blood collection:<\/span><\/b> <a href=\"https:\/\/eu.bd.com\/iv-news\/scientific-publications\/scientific-publication-evaluation-of-processes-outcomes-and-use-of-midline-peripheral-catheters-for-the-purpose-of-blood-collection1\/\">Evaluation of processes, outcomes and use of midline peripheral catheters for the purpose of blood collection<\/a><\/p>\n<h4><b><span data-contrast=\"auto\">Midline catheters vs PICC lines<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/h4>\n<p><span data-contrast=\"auto\">Prof Mussa stated that according to recent literature, peripheral intravenous catheters (PIVCs) are known as the most common invasive hospital procedure performed worldwide and have an unacceptably high overall failure rate of 35-50%.<\/span><sup><span data-contrast=\"auto\">5<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">From his Cuneo Hospital ED study, Prof Mussa presented the rate of complications in patients after 1 day, 3 days and 7 days with central venous catheters.<\/span><span data-contrast=\"auto\">1<\/span><span data-contrast=\"auto\"> He explained that after 3 days, only 51.9% of patients reported no complications, and after 7 days, that number dropped to 14.16%.<\/span><sup><span data-contrast=\"auto\">1<\/span><\/sup><span data-contrast=\"auto\">\u00a0<\/span> <span data-contrast=\"auto\">Prof Mussa cited various studies in support of midline catheters and their lower risk of adverse events and complications when compared to PICC lines.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">One prospective study concluded that for 94 midline catheters in hospitalized patients, only 3.5 mechanical complications and 1.1 events of thrombosis\/phlebitis were recorded per 1000 catheter days, with an average dwell time of 27 days.<\/span><sup><span data-contrast=\"auto\">6<\/span><span data-contrast=\"auto\">\u00a0<\/span><\/sup><\/p>\n<p><b><span data-contrast=\"auto\">Learn more about midline catheters:<\/span><\/b> <a href=\"https:\/\/eu.bd.com\/iv-news\/news-innovation\/bd-provena-midline-catheters\/\">BD Provena\u2122 Midline Catheters<\/a><\/p>\n<h4><b><span data-contrast=\"auto\">Are midline catheters the answer for ED patients?<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/h4>\n<p><span data-contrast=\"auto\">Despite all this evidence in support of midline catheters, Prof Mussa said, the data changes completely when in an emergency setting.<\/span><sup><span data-contrast=\"auto\">1<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><iframe title=\"Are midline catheters underused in the emergency department?\" width=\"640\" height=\"360\" data-src=\"https:\/\/www.youtube.com\/embed\/y1-YYurLApA?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" class=\"lazyload\" data-load-mode=\"1\"><\/iframe><\/p>\n<p><span data-contrast=\"auto\">In one observational study of midline catheter placement in the ED, the average dwell time was only 8 days with substantial variation, and the majority of midline catheters were removed prematurely due to complications.<\/span><sup><span data-contrast=\"auto\">7<\/span> <\/sup><span data-contrast=\"auto\">Prof Mussa speculated that this could be due to the rapid nature of the insertion procedure in the ED, as well as insufficiently trained staff.<\/span><sup><span data-contrast=\"auto\">1<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Learn more about midline catheters in the ED:<\/span><\/b> <a href=\"https:\/\/eu.bd.com\/iv-news\/events-training\/new-advances-in-midline-applications-a-wocova-2021-symposium\/\">New advances in midline applications \u2013 a WoCoVA 2021 symposium<\/a><\/p>\n<h4><b><span data-contrast=\"auto\">Studying the BD PowerGlide Pro\u2122 Midline Catheter in the ED<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/h4>\n<p><span data-contrast=\"auto\">If even midline catheters are less effective in the ED, how do we combat this to ensure effective vascular access for emergency patients?<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Prof Mussa introduced the BD PowerGlide Pro\u2122 Midline Catheter, which was designed to be easy to place with its \u201cno-touch\u201d technology.<\/span><span data-contrast=\"auto\">1<\/span><span data-contrast=\"auto\"> He explained that it is especially user-friendly for ED nurses who are untrained in placing PICC lines because its insertion is similar to that of a cannula (PIVC).<\/span><span data-contrast=\"auto\">1<\/span><span data-contrast=\"auto\"> As well, thanks to its closed structure, it is \u201cimpossible to contaminate.\u201d<\/span><sup><span data-contrast=\"auto\">1<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><span data-contrast=\"auto\">He conducted a study of the BD PowerGlide Pro\u2122 Midline Catheter at the Citta Della Salute Hospital in Turin, Italy, where nurses for 300 emergency medical and surgical patients were observed in their abilities to place the midline catheter.<\/span><sup><span data-contrast=\"auto\">1<\/span><span data-contrast=\"auto\">\u00a0<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Nurses were given device care bundles for catheter placement and management as well as basic training on implant management.<\/span><span data-contrast=\"auto\">1<\/span><span data-contrast=\"auto\"> However, he insisted that they were not specially trained vascular access nurses, but general ED nurses.<\/span><sup><span data-contrast=\"auto\">1<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><span data-contrast=\"auto\">The team found that among the 300 patients, 283 midline catheters were successfully placed, with only 23 reported complications, of which 12 led to removal.<\/span><sup><span data-contrast=\"auto\">1<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><span data-contrast=\"auto\">This data shows a complication rate of 4.9%, where typical midline catheters resulted in a 10% complication rate.<\/span><sup><span data-contrast=\"auto\">1<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">In conclusion, Prof Mussa stated that the BD PowerGlide Pro\u2122 Midline Catheter appears to be the correct choice for patients with infusion needs typical of the ED.<\/span><sup><span data-contrast=\"auto\">1<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<h4><b><span data-contrast=\"auto\">About BD MACOVA 2022\u00a0<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/h4>\n<p><span data-contrast=\"auto\">BD MACOVA 2022 was held in Berlin on the 8-10th June and welcomed over 300 guests and 31 speakers from 35 countries.\u00a0\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">The event carries a rich history of engaging leaders in vascular access (VA) to share their experience and insight into vascular access management (VAM) with those looking to expand the use of vascular access devices and services they provide in their hospitals.\u00a0\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">This year\u2019s theme was to create a VA community of VAM-bassadors (Vascular Access Management Ambassadors) of change to help improve patient outcomes.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><b><span data-contrast=\"auto\">Learn more about MACOVA 2022: <\/span><\/b><a href=\"https:\/\/eu.bd.com\/iv-news\/events-training\/what-is-new-uk-vessel-health-and-preservation\/\"><b><span data-contrast=\"none\">What\u2019s new in U.K. Vessel Health and Preservation 2020?<\/span><\/b><\/a><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n    <div id=\"newslettercta\">\n        <div class=\"tnp tnp-subscription-minimal newsregister\">\n            <form method=\"post\" id=\"newsletter_form\">\n                <input id=\"email_newsletter\" class=\"tnp-email\" type=\"email\" required placeholder=\"Email\">\n                <input id=\"submit_newsletter\" class=\"tnp-submit\" type=\"submit\" value=\"Subscribe\">\n\n                <label>\n                    <input type=\"checkbox\" name=\"accept\" required \/>\n                    <small>\n                        Send me the BD IV News newsletter. I expressly agree to receive the newsletter and know that I can easily unsubscribe at any time.                    <\/small>\n                <\/label>\n                <p id=\"validamessage\" style=\"display: none;color: #00b8b0;margin: 5px 0;\">\n\n                    Thank you for your registration.\n                <\/p>\n            <\/form>\n        <\/div>\n    <\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n","protected":false},"excerpt":{"rendered":"<p>\u201cIn the ED [emergency department], time is chief,\u201d said Professor Baudolino Mussa, Vascular Access Surgeon and Professor of Vascular Access&#8230;<\/p>\n","protected":false},"author":8,"featured_media":5002,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[13,5618],"tags":[],"class_list":["post-5000","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-events-training","category-gated-content","speciality-critical-care-emergency-care","contenttype-article","target-doctor","target-hospital-director-manager"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Are midline catheters underused in the emergency department?<\/title>\n<meta name=\"description\" content=\"Choosing between midline catheters vs PICC lines in the emergency room, and how the BD PowerGlide Pro\u2122 Midline Catheter can benefit ED patients.\" \/>\n<meta name=\"robots\" content=\"index, follow, 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