1. Consider infusate characteristics in conjunction with anticipated duration of treatment (eg, 1-4 weeks.)
2. Consider a midline catheter for medications, and solutions, such as antimicrobials, fluid replacement, and analgesics with characteristics that are well tolerated by peripheral veins.
3. Do not use midline catheters for continuous vesicant therapy, parenteral nutrition, or infusates with an osmolarity greater than 900 mOsm/L.
4. Use caution with intermittent vesicant administration due to risk of undetected extravasation. The administration of vancomycin for less than 6 days through a midline catheter was found to be safe in one study.
5. Avoid the use of a midline catheter when the patient has a history of thrombosis, hypercoagulability, decreased venous flow to the extremities, or end-stage renal disease requiring vein preservation.
Source: Journal of Infusion Nursing Volume 39,Number 1S
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