Right Device PICCs and Midline Catheters

Peripherally inserted central catheters (PICCs), inserted through a peripheral vein of the arm, leg, or scalp, provide reliable central venous access for patients who require intravenous therapy for several days to an indefinite period. The central venous position of the distal catheter tip allows for the infusion of irritant and vesicant solutions, as well as reliable access for drawing blood for laboratory analysis. However, there are contraindications and risks related to PICCs. The risk–benefit analysis must be considered prior to the insertion of a PICC. Midline catheters are shorter than PICCs, longer than peripheral catheters, providing venous access options for patients who require intravenous (IV) access and infusates that do not require central venous access for treatments that are well- tolerated when administered IV peripherally (Nickel et al. J Infus Nurs 47(1S):S1–S285, 2024). Midlines also have some contraindications and risks associated with their use. It is the responsibility of the vascular access specialist to determine when the insertion and use of these devices are in the best interests of safe and effective patient care.