Module 5: Midline Catheter Insertion

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1. What is a Midline Catheter?

A midline catheter is a peripheral vascular access device typically 3–8 inches (8–20 cm) in length, inserted via the basilic, cephalic, or brachial vein of the upper arm. The tip terminates in the axillary region or just below the axilla — it does not enter central circulation and is therefore classified as a peripheral device, not a CVAD.

The midline occupies a critical niche between the short peripheral IV and the PICC line, offering extended dwell time and improved stability while avoiding the risks associated with central venous access.

Common Clinical Error Midline catheters are frequently confused with PICC lines. The most important distinction is tip location — a midline tip is PERIPHERAL (below the axilla) while a PICC tip is CENTRAL (distal SVC or CAJ). Therapies appropriate only for central access must NEVER be administered through a midline.

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