I. V. ROUNDS: Managing complications of midlines and PICCs

June 2005 
Volume 35  Number 6
Pages 68 - 69
  PDF Version Available!


  • Warming up to phlebitis

  • Catheter occlusion: Clearing the way

  • Breaking up thrombosis

  • Fighting infection

  • Put the brakes on migration

  • Catheter fracture or embolism

  • Air embolism emergencies

  • Dealing with a difficult removal


    OVERALL, the complication rate for midline catheters and peripherally inserted central catheters (PICCs) is low, but you still need to know how to deal with problems. Here we'll discuss how to prevent some common complications and intervene if problems occur.

    Warming up to phlebitis

    An inflammation of the vein, phlebitis is characterized by redness, swelling, tenderness, and warmth along the catheterized vein and may have a mechanical, chemical, or infectious cause. Mechanical phlebitis usually occurs within the first week of catheter insertion and responds to warm compresses and arm elevation. Chemical phlebitis is triggered by the infusion of irritating I.V. drugs. Infectious phlebitis occurs when bacteria infect and damage the vein lining.

    Prevention: Don't infuse irritating solutions through a midline catheter. Avoid placing the catheter in an area of flexion and secure the catheter to prevent migration. Perform hand hygiene and use aseptic technique when providing site care and administering therapy.

    Interventions: Notify the prescriber. To treat mechanical phlebitis, apply warm compresses, elevate the arm, and give analgesics. Remove the catheter if signs and symptoms don't resolve or if phlebitis occurs after more than a week after catheter insertion.

    Catheter occlusion: Clearing the way

    Partial or complete catheter occlusion limits or prevents blood aspiration, flushing, or administering solutions or drugs. Occlusions can be nonthrombotic (caused by drug precipitates or mechanical ...

Purchase Now !

To purchase this item, follow the instructions below. If you’re not already logged in, be sure to enter your login information below to ensure that your item is saved to your File Drawer after you purchase it.

Not a member? Join now for Free!

1) If you're not already logged in, enter your information below to save this item in your File Drawer for future viewing.

User name:


Forgot your user name or password?
2)  If you have a coupon or promotional code, enter it
here.(If not, just click Continue.

Digital Coupon: (optional)

3)  Click Continue to go to the next screen, where
you'll enter your payment details.

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Debunking Three Rape Myths
Journal of Forensic Nursing, October/December 2014
Expires: 12/31/2016 CE:2.5 $24.95

Drug updates and approvals: 2014 in review
The Nurse Practitioner, 13December 2014
Expires: 12/31/2016 CE:3 $27.95

Can Food Processing Enhance Cancer Protection?
Nutrition Today, September/October 2014
Expires: 10/31/2016 CE:2 $21.95

More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events