Collaborative Intravenous Nursing Service (CINS) Guidelines

Peripheral Midline - 0.9% Sodium Chloride and Heparin 10 units/ml in 0.9% Sodium Chloride for injection Lock (PM2) (At leastonce daily, more frequently if required)It is not always possible to aspirate blood from a peripheral midline, as the lumen of the catheter is small47ActionEquipment RequiredDressing Pack containing sterile towel and glovesGauze swabs x 310ml syringes x 3Chlorhexidine Gluconate 2% in 70% Isopropyl alcohol or 2% Chlorhexidineimpregnated wipe.10ml 0.9% Sodium Chloride for injection5mls Heparin 10units/ml in Sodium ChlorideTwo green needles/filter straws. Sharps containerSurgical tapeAlcohol hand rubPlastic apronNeedle free I/V access connector change as per manufacturer’s guidelines seeNSF1 Cins guideline Before the procedure begins make sure that your hands are washed and driedthoroughly and that they continue to be decontaminated during the procedure. A plasticapron should be worn.• Maintain aseptic technique at all times.• Explain the procedure to the patient. Ensure that valid consent is gained.• Inspect the catheter exit site for signs of inflammation or signs of infection e.g.exudates from exit site. If you suspect infection please contact the hospital team whoplaced the catheter for advice. Refer to trouble-shooting guide.• Ensure working area is as clean as possible.• Ensure all equipment is gathered before commencing the procedure and all packagingis intact and in date.• Open sterile pack allowing inner pack to fall onto clean working area.Rationale10 ml syringes should always be used.Smaller syringe sizes may damage thecatheter (Hadaway 1998)Maintain asepsis.Reduce risk of infection.Reduce anxiety and improve patientcomplianceChlorhexidine based solutions arerecommended (in alcohol) dependenton the availability and catheterThe CINs group hereby assert their moral rights tothe works herein in accordance with the Data Protection Act 1988.Policy review date 01/10/10