Single Lumen Midline Catheter vs Long Peripheral Intravenous Cather for Difficult Intravenous Access in the ED
Recruiting now · Not applicable
Conditions studied: Difficult Intravenous Access, Midline Catheter, Peripheral Intravenous Catheter, Emergency Department Patient
In brief
Many patients in the emergency department have veins that are difficult to get an intrevenous (IV) catheter into (called "difficult IV access"). These patients may require other methods to obtain access to a vein for administration of the necessary medications. The 2-inch long IV is most commonly used in emergency departments for people with difficulty IV access. Typically, a healthcare worker will use an ultrasound to help to see the veins underneath the skin while inserting the IV into the vein. That is, the ultrasound helps the healthcare worker visualize veins that are deeper in the arm and may not be felt through the skin. Another device that can be used is a 4-inch midline catheter. This device is less commonly used as many emergency departments do not have participants available, but it serves the same purpose as the 2-inch long IVs (that is, to give medicine into the vein and sometimes to take blood). A 4-inch midline catheter is similar to a 2-inch long IV, but has a few differences. First, the 4-inch midline catheter is even longer than the 2-inch long IV. The 4-inch midline catheter is 10-cm (about 4-inches or the size of 4 quarters side-by-side), while the 2-inch long IV is 4.78-cm (nearly 2-inches or two quarters side-by-side). Second, the 4-inch midline catheter is inserted into using a guidewire to help move the catheter in the vein (similar in concept to a train moving along a track), while the 2-inch long IV does not have this guidewire. The guidewire does not hurt and most do not know it is being used. It is just an additional step to help guide the catheter in the vein. The investigators are conducting this research study to determine which catheter is better for patients with difficult IV access: the 4-inch midline catheter or the 2-inch long IV.
Key facts
- Study ID
- NCT06668766
- Run by
- Albany Medical College
- People needed
- 270
- Starts
- 2025-01-01
- Expected to finish
- 2027-10-21
- Last updated by the study team
- 2026-01-20
Who can join
Age: 18 and older. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Adult (age 18 and older) patients presenting to the AMC ED with difficult IV access defined as any of the following:
- Two failed attempts at landmark based IV or US-guided peripheral vascular access by qualified ED staff
- Self-reported history of difficult IV access and one of the following:
- History of requiring 2 or more IV attempts on a previous visit (either self-reported or documented in the electronic medical record)
- Previous requirement for a rescue device after failed IV access attempt. These devices are as follows:
- US guided PIV
- Midline catheter
- Peripherally inserted central catheter
- Central venous catheter
- Intraosseous catheter
- History of or active comorbid disease state with known difficult IV access
- Prior or current implanted port device
- End stage renal disease with fistula
- Sickle cell disease
- History of or active intravenous drug use
You may not qualify if…
- Patients under the age of 18
- Known Prisoners
- Non-English-speaking patients
- Patients in whom the device cannot be stabilized due to tissue or treatments in bilateral extremities or available extremity (burns, complex humeral fractures, dialysis fistulas etc.)
- Patients lacking capacity to consent
- Patients unable to sign written consent
- Patients without identifiable target veins by ultrasonography
- Known pregnant patients
- Previously enrolled in this study
- Previously withdrawn from this study
- Presented when no study IV proceduralists are available
- Patients in whom obtaining informed consent and being enrolled in the study would put them at risk for obtaining time sensitive medical care
Where it is running
- Albany Medical Center Hospital — Albany, New York, United States (enrolling)
Full record on ClinicalTrials.gov
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