Indications for central venous catheter removal:
1. Lack of indications for further use of the boat.
2. Occlusion of the catheter.
3. Local infectious process or phlebitis.
4. Sepsis and / or positive result of inoculation of blood obtained through a catheter (catheter colonization). There are clinical situations where the catheter is left, despite sepsis. With the help of antimicrobials, they are trying to suppress the infection. However, an increased risk of complications and death is possible.
Central venous catheter removal technique
Surgically established central vein catheters should be removed by a doctor or other medical professional trained in the technique of removing the cuff and / or catheters inserted through the subcutaneous passage.
1. Remove the bandage.
2. Slowly, within 2-3 minutes, pull the catheter out of the vessel.
Do not use force if the catheter has been fixed with a suture, as it may break.
3. Press the injection site of the catheter for 5-10 minutes until the bleeding stops.
4. Inspect the catheter (without compromising the sterility of the tip) to ensure that it is completely removed.
5. The cuff of the tunneled catheter should be excised under local anesthesia and intravenous sedation. When establishing a cuff, a stable subcutaneous tumor can rarely occur; sometimes it can break through the skin.
6. Optionally, an ointment with an antibiotic can be applied to the site of removal of the catheter.
7. Apply a small patch or gauze dressing, examine the wound daily until healing begins.
- sterile tray, test tube, scissors
- waste tray
- sterile gauze balls
- adhesive plaster
- thrombolytic ointment
- antiseptic for skin treatment - 700 alcohol
- bottle with a 0.5% solution of chlorhexidine bigluconate
- sterile gloves
Peripheral venous catheter
1. Prepare the limb of the patient, calm him,
2. Explain the progress of the upcoming manipulation.
3. Wash hands.
4. Stop the infusion.
5. Remove the protective bandage.
6. To process hands twice with a 0.5% solution of chlorhexidine bigluconate.
7. Wear sterile gloves.
8. Remove the retaining bandage (without scissors), moving from the periphery to the center.
9. Carefully and slowly withdraw the catheter from the vein.
10. Press the catheterization site with a sterile gauze swab.
11. Treat the site of catheterization with 700 alcohol twice.
12. Apply a sterile pressure dressing to the sterilization site.
13. Fix the bandage with adhesive tape.
14. Check the integrity of the catheter cannula.
15. If there is a blood clot or suspected catheter infection, cut off the tip of the cannula with sterile scissors.
16. Place the cut tip of the cannula in a sterile tube.
17. Refer to the bacteriological laboratory for research.
18. Note in the documentation the time, date and reason for removal of the catheter.
19. Dispose of the used catheter in accordance with safety regulations and the sanitary-epidemiological regimen.
Note. Despite the fact that catheterization of peripheral veins is less dangerous than catheterization of central veins, it is fraught with complications, like any procedure that violates the integrity of the skin. However, most of the complications can be avoided if the nurse is well versed in manipulation techniques, the rules of aseptic and antiseptic are strictly followed, and proper care is installed for the catheter.