P-15552-301B Arrowg+ard Blue Advance Midline Catheter User Guide

Arrowg+ard Blue Advance® Midline Catheter
Patient Information Booklet

Introduction:

Your doctor has requested that a Midline be inserted for your medical treatment. This booklet has been given to you to provide information about the Arrow® Midline. Use it in addition to the directions you have received from your healthcare provider.
A midline is a small tube that is placed into a blood vessel in one of your arms and the tip is advanced to a position just below your shoulder. Medications or fluids can be given through the catheter for an illness that requires treatment over a period of time. A midline is an alternative to having repeated needle sticks or surgery to place another kind of intravenous (IV) device.
The midline consists of a long, hollow tube (lumen) with one (or more) holes at the tip that lies within the body and a hub at the other end that is outside of the body on the arm surface (refer to Figure 1). Medications or fluids can be given through the hub continuously or injected periodically.

Catheter Care and Maintenance:

Dressings:
The insertion site and external portion of the midline should be covered with a protective dressing. The dressing will help to hold the catheter in place and keep the area clean and protected from germs.
Because the catheter is small and pliable, the catheter body can be anchored in place by using stitches, sterile tape strips or a special anchoring device. The special anchoring device consists of a catheter clamp and a crescent- shaped adhesive strip. The strip is placed on the arm and the catheter clamp that has been applied to the catheter is snapped into place (refer to Figures 2 and 3). Another dressing, either gauze or a transparent sheet, is placed over the site as a final protective measure.

If you or a family member have been trained to redress your catheter, follow the directions given by your healthcare provider. Be sure to wash your hands prior to starting the procedure and use sterile technique as you have been instructed. As a safeguard, do not use sharp instruments such as scissors during the dressing change to avoid accidentally cutting your catheter. Inspect the insertion site regularly for any redness or drainage, and watch the catheter to make sure it does not move in or out further than when it was inserted. If the dressing becomes loose, make sure that it is changed. If your catheter is accidentally removed, immediately cover the site with an occlusive dressing and contact your healthcare provider.

Flushing:

To keep your midline open to flow, it may be flushed and filled with sterile normal saline or an anti-clotting solution. The solution keeps blood from backing up into the lumen and forming a clot. When the catheter is not in use the extension line should be clamped or the infusion hub should be capped with an add-on device provided by your healthcare provider. If you or a family member are caring for your catheter, follow the directions given by your healthcare provider. They will tell you what solution should be used as well as the amount that should be given and how often the catheter should be flushed.

Complications:

Although you should not expect a problem to occur that is related to your midline, it is important that you become familiar with the signs and symptoms that might signal such a problem. See the following table.

Your midline catheter has the special infection protection coating of chlorhexidine, you need to be aware of the possible allergic reaction(s) associated with the use of  chlorhexidine
Redness at insertion site, hives, itching, anxiety, chest discomfort or tightness, cough, difficulty breathing, difficulty swallowing, abnormal (high- pitched) breathing sounds, dizziness or light-headedness, flushing or redness of the face, nausea or vomiting, palpitations, swelling of the face, eyes, or tongue, unconsciousness, wheezing| Allergic reaction to chlorhexidine
Most severe allergic reactions occur within seconds or minutes after catheter insertion when you will be in the presence of the nurse or doctor, however, some reactions can occur after several hours
Anaphylaxis is the severest reaction which can occur
It occurs suddenly and within minutes of catheter insertion and immediate medical attention is needed| Tell the nurse or doctor about any of these symptoms while the catheter is being inserted or as they occur| Inform the doctor or nurse of any allergies associated with chlorhexidine before having the catheter inserted
Drainage, redness, pain, swelling around insertion site, fever and chills| Infection| Call doctor or nurse| Use sterile technique
Keep sterile dressing over site Wash hands prior to procedures
Arm or shoulder swelling, swishing in ear on same side of body where catheter is located while medication given| Catheter position change| Call doctor or nurse
Do not inject any solutions into catheter until talking with doctor or nurse| Inject flushing/locking solution slowly
Inability to inject| Catheter clotted or kinked| Call doctor or nurse| Completely fill catheter lumen with locking solution between treatments
Flush catheter well before and after medications
Catheter leaking| Break in catheter material, hub separation, loose connection to infusion hub| Call doctor or nurse
Fold catheter together below leaking area and tape securely| Do not remove clamps from extension lines, where provided
Do not use alcohol or acetone (as in nail polish or tape remover) on catheter
Do not pull on catheter
Do not clamp extension line too close to infusion hub
Properly tighten connectors to infusion hub
Do not use a syringe smaller than 10 mL with your catheter
Pain on injection| Inflammation of vein| Call doctor or nurse| Medications should be given slowly

Questions:

The following questions cover topics concerning your daily routine while your midline is in place. You may want to discuss these and other topics with your healthcare provider.

• May I bathe/shower and swim while my catheter is in place? It is recommended that you do not submerge your catheter site in water.
  An occlusive dressing should be used to ensure the site remains dry.

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• How often should my dressing be changed? Your dressing should be changed every 7 days or immediately if soiled or wet.

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• How often should my catheter be flushed and what solution should be used? Your catheter should be flushed before and after each use. Or at a minimum of once per week when not in use.

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  To be filled in if necessary, by your healthcare provider:
  Exposed Catheter Length:
  Length of catheter inserted:
  Notes: _____
  Symbol Glossary: Symbols are in compliance with ISO 15223-1.
  Some symbols may not apply to this product. Refer to product labeling for symbols that apply specifically to this product.

Arrow, the Arrow logo, Arrowg+ard Blue Advance, Teleflex, and the Teleflex logo are trademarks or registered trademarks of Teleflex Incorporated or its affiliates, in the U.S. and/or other countries. © 2021 Teleflex Incorporated. All rights reserved.

Arrow International LLC
3015 Carrington Mill Blvd., Morrisville, NC 27560 USA
USA: 1 866 246 6990 | International: +1 919 544 8000

P-15552-301B, Rev. 1 (2021-06)

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