Which line type is not recommended for infusion of vesicant medications due to higher risk of infiltration?

• A. Implanted port
• B. Midline catheter
• C. 18-gauge peripheral IV
• D. PICC line

Answer: (B)

Vesicants can cause serious tissue injury if they infiltrate into surrounding tissue, so delivering them through pathways that place the drug into a central, high-flow vein minimizes local exposure and damage.

Implanted ports and PICC lines are central venous access devices; their tips sit in central veins, allowing rapid dilution of the medication in circulating blood and reducing the chance of local tissue injury if a small amount leaks out.

A midline catheter, however, ends in veins of the upper arm and does not reach the central circulation. Because it stays in smaller peripheral veins, vesicants carried through a midline have a higher risk of causing infiltration and tissue damage, making this line less suitable for vesicant therapy.

The 18-gauge peripheral IV is a peripheral line as well, and while it is not central, it’s still a peripheral conduit. However, the key point is that central lines offer the safest route for vesicants due to better dilution in central circulation, whereas a midline sits in peripheral veins and carries a higher infiltration risk.