Midline catheter

Your child might be sent home from hospital with the midline catheter still inserted. You will need to make sure the midline catheter is well taken care of to avoid infection and keep it working properly.

Your child’s doctor or nurse will give you instructions on how to take care of the midline catheter. Your child will also have check-ins with the hospital in the home (HITH) nurse to make sure everything is working properly.

The following tips can help you look after the midline catheter

Hygiene

• wash hands carefully and wear gloves when changing the dressing and cleaning the skin around the midline catheter.

Showering

• make sure the dressing is kept clean and dry at all times
• for baths, make sure the midline catheter is kept out of the water to prevent infection
• for showers, cover the midline catheter with plastic clingwrap and use tape at each end so it stays dry.

Dressing

• check the dressing throughout each day to make sure it is secure and not peeling off
• change the dressing every 7 days, carefully following the instructions given by your child’s treatment team
  • changing the dressing can involve carefully removing the old dressing and cleaning the skin with antiseptic solution, before applying a new clean dressing.

Checking the midline

• check the midline catheter to make sure it is not kinked or bent
• make sure the Needleless Access Device (NAD) on the end of the catheter stays connected at all times
• be careful when helping your child to get dressed, making sure the midline catheter is not accidently removed.

Avoiding damage

• make sure that your child does not do any contact sports or rough play to avoid damage to the midline catheter
• do not allow anyone to touch the midline catheter.

The following information is about issues that can happen with a midline catheter at home, and what to do.

The midline is accidently removed 

1. lie your child down and apply firm pressure over the site with cotton wool or a clean disposable towel for 5 minutes to stop the bleeding
2. cover the site with a spare dressing 
3. contact your child’s treatment team or HITH nurse.

The infusor is disconnected from the midline 

1. clamp the midline, do not attempt to reconnect
2. contact your child’s treatment team or HITH nurse.

The midline breaks 

1. stop the infusion 
2. using the clamp on the midline, clamp above the break closest to the skin where the midline has been inserted 
3. if you are unable to clamp the midline, bend the midline above the break and tape the midline firmly together 
4. cover with a gauze square or a clean disposable towel to keep clean 
5. secure the midline with a spare dressing
6. contact your child’s treatment team or HITH nurse.

The Needleless Access Device (NAD) has fallen off

1. camp the midline immediately 
2. if you are unable to clamp the midline, bend the midline above the break and tape the midline firmly together 
3. attach a new NAD to the end of the midline, DO NOT replace the old NAD back onto the midline 
4. If you do not have a spare NAD, wrap the end of the midline with the spare dressing and apply tape around this dressing and midline 
5. contact your child’s treatment team or HITH nurse.

Your child develops a fever or signs of infection

Stop the infusor, clamp the midline, call your child’s HITH nurse, and take your child to the nearest emergency department if they develop:

• a fever
• swelling, redness, or pain at the entry site
• swelling, redness or pain up the arm.

The dressing is loose, wet or dirty

1. do not remove the dressing
2. secure the dressing with spare, clean dressing
3. contact your child’s treatment team or HITH nurse.

The midline appears longer or shorter

1. secure the midline with spare dressing to prevent further movement
2. contact your child’s treatment team or HITH nurse.

There is leaking or drainage at the entry site

1. stop the infusor and clamp the midline
2. contact your child’s treatment team or HITH nurse.

There is blood in the midline 

1. stop the infusor and clamp the midline
2. contact your child’s treatment team or HITH nurse.

Your child will have the midline catheter removed when treatment is finished, or it is not working like it should be. The midline catheter can be removed easily by a specially trained doctor or nurse. Your child will not need to go under general anaesthetic to have the midline catheter removed.

Flushing is when a normal salt water or saline solution is pushed in the midline catheter by a syringe. This helps to stop it from becoming blocked and is done after medication has been given.

Locking is when an anti-blood clotting and antibacterial solution is left in the midline catheter when it is not being used. This is typically done when the midline catheter does not need to be used for up to one week and stops infection from happening and the line from becoming blocked.

Because the midline catheter sits inside the body, there is a small risk that it could damage or puncture the wall of blood vessels. A serious infection or blood clot could also develop. These complications are extremely rare but can be life threatening.

Your child’s doctor will talk to you about the midline catheter, the risks and the benefit before your child has the procedure. Make sure you ask any questions you have about the midline catheter and caring for the line.