First catheterization of Mini midline in Northwest Womens and Childrens Hospital

With the popularization of new technologies in clinic infusion therapy , infusion tools are constantly updated, and a variety of infusion puncture methods are selected in the clinic.

On June 29, 2022, with the support of the Nursing Department and the guidance of the head nurse Chen Qun, the Department of Breast Nail Surgery of Northwest Women and Children's Hospital successfully performed the first mini midline catheterization for a patient with hyperemesis gravidarum.

Due to severe vomiting gravidarum , the patient’s vascular condition is very poor, according to the patient's vascular condition and the expected treatment time. The doctor decided to insert a Mini midline for the patient, so there’s no repuncture during her hospitalization .The insertion of the Mini midline has been well received by the patient and her families: "No longer have to worry about the pain of repeated punctures and the trouble of needle-off ".

As a new intravenous treatment access , the Mini Midline better fills the gap in the indwelling time of peripheral indwelling needle (3-5 days) and PICC (1 month to 1 year).

Mini midline or long peripheral cannula?

One 8cm to 10cm long catheter can be directly punctured into deep veins by ultrasound guidance with Seldinger technique. A catheter that can also be inserted in a shallow vein by traditional puncture technique is known as a mini midline catheter also called long peripheral cannula.

How to measure the end position of the Mini Midline

1.Stretch the patient's arm in 90 degrees.

2. Place the index finger under the patient's armpit and wrap your thumb around the upper arm (if the patient is catheterized on right arm, the surgeon needs to measure it with the left hand, and vice versa)

3. This point as below picture shows is considered to be the end position of Mini midline.

☑ Indications:

1. Can be infused with antibacterial drugs, rehydration fluids and  analgesics that are well tolerated by peripheral veins.

2. Intermittent infusion of known strong stimulation, foaming agent drugs. Highly focus on the supervision of the catheter puncture site , as it would increases the risk of phlebitis and fluid extravasation.

☒ Contraindications:

1.  can not be used for persistent infusion of foaming agent drugs, parenteral nutrition or  solutions with extreme PH or osmolality  .

1. Do not suitable for patients with end-stage renal disease, patients with a history of thrombosis, hypercoagulable state, and patients with slowed peripheral venous blood flow.

Advantages of mini midline catheter

• catheter indwelling time is : 1-2 weeks  
• protect blood vessels, avoid the pain of repeated puncture
• ultrasound -guide technique increases the catheter insertion success rate, safe use, low infection rate, few complications, simple and safe operation, no need for stitches
• does not affect patients’ basic daily life
•  no need for X-ray tip positioning, reduces iatrogenic injury
• Suitable for patients whit poor peripheral vascular conditions

Note: This article is reproduced from the subscription account of Northwest Women and Children's Hospital, and the content is only used for communication and referencing.