Ultrasound Guided Ultra-LongIV’s and Midlines Substance Use Disorder and Clinician Bias

This month marks our third virtual JC on Zoom and I want to thank everyone for making the best of it. Participation has been high and it’s uplifting to see all of your smiling faces, have you share your anecdotes and of course the lovely Covid hairdos. Because of the Memorial Day holiday, we generally have JC a week early so as not to interrupt your beach-going and backyard barbecues. If nothing else, let’s hope Spring finally declares herself and you have an enjoyable Memorial weekend, nonetheless. We are going to be looking at two ultrasound articles on the use of midline catheters. Both are reasonably well done methodologically however, I’ll be looking forward to the discussion regarding the logistics, impact on provider time and facility of skill acquisition. One of the articles claims a single SIM session yielded an almost 100% success rate. Dr. Apgar has an interest in effective management of patients with Substance Use Disorder (SUD) and I expect a great deal of useful discussion on how to manage this oftentimes challenging patient population. I have included two articles and we welcome the participation of those of you with expertise in managing these patients in out-patient settings. 

Bahl et al., Ultralong Versus Standard Long Peripheral Intravenous Catheters: A Randomized Controlled Trial of Ultrasonographically Guided Catheter Survival. Ann Emerg Med. 2020 Jan 16. Appraisal 

Spiegel RJ et al., The Utility of Midline Intravenous Catheters in Critically Ill Emergency Department Patients. Ann Emerg Med. 2020 Apr;75(4):538-545. Appraisal

Mendiola et al., An Exploration of Emergency Physicians' Attitudes Toward Patients With Substance Use Disorder. J Addict Med. 2018 Mar/Apr;12(2):132-135: 

Bernstein S., D’Onofrio A promising approach for emergency departments to care for patients with substance use and behavioral disorders. Health Aff. 2013 Dec;32(12):2122-8.