Name of the Procedure:

Home Infusion Therapy, Midline Catheter Insertion

• Common Name: Midline Catheter Placement
• Technical Term: Home Infusion Therapy with Midline Catheter (HCPCS Code: S5521)

Summary

Home infusion therapy involves the administration of medications or nutrients via a catheter inserted into a vein in the comfort of a patient's home. A midline catheter is a type of intravenous access device that stays in place longer than a typical IV line and is used for treatments requiring more than a few days of infusion.

Purpose

• Medical Conditions: Long-term administration of antibiotics, hydration fluids, chemotherapy, or other intravenous medications.
• Goals: To provide continuous or intermittent medication, to avoid frequent hospital visits, and to enhance patient comfort and convenience by allowing treatment at home.

Indications

• Chronic infections requiring extended courses of antibiotics.
• Conditions necessitating long-term intravenous medication.
• Patients requiring hydration therapy.
• Nutritional support via parenteral nutrition.

Preparation

• Pre-Procedure Instructions: Follow specific dietary or medication guidelines provided by your healthcare provider. Generally, no fasting is required.
• Diagnostic Tests/Assessments: Blood tests to check for clotting factors, patient history review to assess suitability for the procedure.

Procedure Description

1. Setup: All necessary supplies, including the catheter, are prepped. This might be done by a home health nurse or other qualified professional.
2. Vein Identification: The healthcare professional identifies an appropriate vein, usually in the upper arm.
3. Catheter Insertion: The skin is cleaned with an antiseptic solution. The catheter is inserted into the vein using a needle.
4. Catheter Securing: Once in place, the catheter is secured using a sterile dressing to keep it in place.
5. Infusion Setup: The necessary medication or fluids are connected to the catheter for administration.

• Tools and Equipment: Sterile midline catheter kit, antiseptic solution, sterile dressings, infusion pump (if required).
• Anesthesia/Sedation: Local anesthesia is typically used to numb the insertion site.

Duration

The insertion usually takes about 30 to 60 minutes.

Setting

Performed at the patient's home by a healthcare professional, most commonly a trained nurse.

Personnel

• Home health nurse or specially trained infusion therapy provider.

Risks and Complications

• Common Risks: Minor bleeding, discomfort at the insertion site.
• Rare Risks: Infection, thrombosis (blood clots), catheter occlusion or displacement.
• Management of Complications: Immediate contact with healthcare provider for infection signs, regular monitoring and maintenance of the catheter site.

Benefits

• Improved quality of life by receiving treatment at home.
• Reduction in hospital visits and associated costs.
• Convenience and comfort.
• Enhanced adherence to the treatment plan.

Recovery

• Post-Procedure Care: Regular monitoring of the catheter site for signs of infection or displacement. Proper aseptic techniques during dressing changes.
• Recovery Time: Immediate use post-insertion; no extended recovery period.
• Restrictions/Follow-ups: Adhere to activity restrictions if advised. Schedule follow-up visits for dressing changes and catheter maintenance.

Alternatives

• Peripheral IV Lines: Shorter-term, less invasive but need frequent replacements.
• PICC Lines (Peripherally Inserted Central Catheter): Longer-term use but higher infection risk and requires a radiology unit for placement.
• Central Venous Catheters: For patients needing very long-term treatment but comes with higher complexity and risks.
• Pros and Cons: Midline catheters offer a balanced option of medium-term use with fewer complications than PICC or central lines.

Patient Experience

• During the Procedure: Mild discomfort at the site of insertion; local anesthesia minimizes pain.
• After the Procedure: Minimal pain; some may experience mild soreness at the site.
• Pain Management: Over-the-counter pain relief if necessary; adherence to hygiene and care instructions to prevent discomfort.