Use a CHG swabstick with a shoveling technique to loosen the CHG pad.ĭiscard dressing appropriately and perform hand hygiene.ĭon sterile gloves and cleanse site. Remove old dressing wearing non-sterile gloves and discard. Care must be taken to ensure that petroleum does not enter the tract before clotting has begun to avoid entry into the bloodstream. Hemostasis is paramount to the prevention of air entry into the tract. Petroleum jelly may make hemostasis more difficult. Add the transparent dressing to the tray.īacteria can access the catheter tract until it has healed completely. Petroleum gel will create an barrier to prevent the entry of air.Open STERILE petroleum gel and apply a small amount in the centre of the gauze square.Add additional chlorhexidine for removal of securement device if required.Perform hand hygiene and prepare dressing tray aseptically using transfer forceps to add supplies. Perform hand hygiene and open central line dressing change tray.ĭon non-sterile gown, gloves, bouffant and mask with face shield. An assistant will be required if tip culture has been ordered.Īdminister analgesic and sedative (if indicated). Field contamination and inadequate hemostatic control can occur if patient is restless, improperly positioned or has pain. A stool helps to position health care provider into optimal position for pressure application and reduces back strain. Adequate and direct pressure is required to stop bleeding from a central venous or arterial catheter.Īssess patient to determine ability to remain flat during application of pressure and obtain assistant if required for positioning. If removing a femoral venous catheter, obtain a bedside stool. Additional site pressure may be required. The catheter site may also influence bleeding risk. Medications that interfere with clotting should also be reviewed. administration of plasma or platelets) or whether removal should be delayed. If the patient has a significant coagulopathy the removal order should be reviewed to determine whether treatment is warranted (e.g. If patient is receiving any medications that affect coagulation (e.g., anticoagulants, fibrinolytics, antiplatelet agents), review with physician prior to removal. If INR/PTT is prolonged (INR > 1.5) or platelets < 50,000 review orders with physician. VASCULAR CONSULT SHOULD BE PERFORMED FOR ARTERIAL CANNULATION ONCE THE VESSEL HAS BEEN DILATED.Ĭheck INR/PTT and platelets. NURSES DO NOT REMOVE A CVC THAT HAS BEEN INADVERTENTLY PLACED INTO AN ARTERY. Perform hand hygiene and don a mask with eye shield and non-sterile gloves prior to blood sampling.Ĭonfirm 2 patient identifiers as per LHSC Policy for Patient Identification This includes tunneled dialysis lines (perm caths).įollow LHSC policies for hand hygiene and infection control before, during and after procedure. Nurses in CCTC are not approved to removed tunneled catheters or implantable ports. Nurses may remove temporary hemodialysis catheters, but should be aware of the large catheter size increases the risk for both bleeding and air embolism. RNs in CCTC may removed temporary central venous access devices including: PICC, Internal Jugular (IJ), Subclavian (SC) and Femoral. Procedure for Removal of Central Venous Catheter (IJ, SC and Femoral) Ensure that patient and health care provider safety standards are met during this procedure including:
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