A midline catheter (MLC) is any percutaneously inserted IV line
that is placed between the antecubital fossa and the head of the
The concept of an MLC is similar to that of a peripherally inserted
central catheter (PICC). It is advanced into larger vessels below
the axilla (basilic, cephalic, and median cubital) where there
is good hemodilution. Because it is inserted into the veins of
the upper arm, rather than those of the central venous system,
it may not (depending on agency policy) require an x-ray to verify
tip placement. The optimal catheter tip location is level with
the axilla, just distal to the shoulder and deltoid muscle.
The MLC is intended for intermediate-term therapy of 1–6
weeks for the delivery of nearly all infusion products, except
chemically caustic materials and total parenteral nutrition (which
require hemodilution in the superior vena cava). It is often used
in the home care situation where around-the-clock nursing care
is not available and where the client can self-administer medications.
The insertion and management protocols for an MLC follow the
same principles and procedural guidelines as described for a PICC
line. The arm must be assessed frequently and carefully as long
as the catheter remains indwelling. Strict adherence to manufacturer’s
recommendations for admixing, diluting, and administering infusates
must be followed. Nursing and medical management of the major
complications associated with MLC use are essentially the same
as for PICC lines.