68: Central Venous Catheter Removal

Published on 06/03/2015 by admin

Filed under Critical Care Medicine

Last modified 06/03/2015

Print this page

This article have been viewed 1090 times

Central Venous Catheter Removal

Teresa Preuss and Debra Lynn-McHale Wiegand

Central venous catheters are removed when therapy is completed, when the presence of the catheter presents a risk for complications (e.g., the catheter is occluded or malpositioned), or when the patient has a catheter-related infection.

PREREQUISITE NURSING KNOWLEDGE

• Knowledge of the normal anatomy and physiology of the vasculature and cardiovascular system is necessary.

• Knowledge of normal coagulation values is needed.

• Principles of aseptic technique should be known.

• Advanced cardiac life support knowledge and skills are necessary.

• Clinical and technical competence in central venous catheter (CVC) removal is necessary.

• Knowledge of the state nurse practice act is important because some states do not allow this intervention to be performed by a registered nurse.

• Knowledge of potential complications associated with the removal of the CVC is needed.

• An air embolism can occur during or after the removal of the catheter as a result of air drawn in along the subcutaneous tract and into the vein. During inspiration, negative intrathoracic pressure is transmitted to the central veins. Any opening external to the body to one of these veins may result in aspiration of air into the central venous system. The pathologic effects depend on the volume and rate of air aspirated. Signs and symptoms include: respiratory distress, agitation, cyanosis, gasp reflex, sucking sound, hypotension, petechiae, cardiac dysrhythmias, and altered mental status.

EQUIPMENT

• Goggles or face shield

• Face mask, sterile glows, nonsterile gloves

• Antiseptic solution (e.g., 2% chlorhexidine-based preparation)

• Sterile scissors

• 4 × 4 gauze pads

• One roll of 2-inch tape

• Two moisture-proof absorbent pads

Additional equipment to have as needed includes the following:

• Additional dressing supplies (e.g., transparent dressing)

• Sterile specimen container (needed if culture of catheter tip will be obtained)

• Antibiotic ointment

• Suture removal kit

• Emergency equipment

PATIENT AND FAMILY EDUCATION

• Explain the procedure to the patient and family and the reason for catheter removal. Rationale: This explanation provides information and decreases anxiety.

• Explain the importance of the patient lying still during the catheter removal. Rationale: This explanation ensures patient cooperation and facilitates safe removal of the catheter.

Buy Membership for Critical Care Medicine Category to continue reading. Learn more here

Related

Aacn Procedure Manual for Critical Care