Selecting a Venous Catheter for Medium- to Long-Term Use - CME

CME

Description: Selection of a venous access device for infusion therapy lasting weeks or months requires consideration of the indication, duration, patient comorbidities, venous anatomy, maintenance needs, and patient preferences (eTable in the Supplement). This article discusses selection of catheters for medium- or long-term use in 4 clinical settings. Until recently, patients prescribed outpatient intravenous antibiotics for 30 or fewer days had only 1 option: the peripherally inserted central catheter (PICC), in which the tip terminates at the cavoatrial junction. Improved catheter materials and design technology have led to increased use of midline catheters that terminate in the veins of the upper extremity. Midline catheters do not require imaging for tip localization, so they can be inserted at the bedside or in outpatient settings. They are also associated with lower risk of catheter-related bloodstream infection (CRBSI) compared with PICCs. However, due to their peripheral location, they are not suitable for long-term irritant or vesicant therapy, including vancomycin and most chemotherapeutics. However, midline catheters are ideal for most outpatient parenteral antibiotic therapy, and recent data show they may be safer than PICCs for this indication.1

Learning Objectives

Specialties: Internal Medicine - General, Family Medicine, Emergency Medicine, Critical Care, Urology, Primary Care

Disclosures and Disclaimers: CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Accredited Providers

Credit Information

Credit Type	Units / Unit Type	Board
AMA PRA Category 1 Credit	1 Credits	ACCME- Accreditation Council for Continuing Medical Education