PROCEDURE 68 • 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. • Face mask, sterile glows, nonsterile gloves • Antiseptic solution (e.g., 2% chlorhexidine-based preparation) Additional equipment to have as needed includes the following: • Explain the procedure to the patient and family and the reason for catheter removal. • Explain the importance of the patient lying still during the catheter removal.
Central Venous Catheter Removal
PREREQUISITE NURSING KNOWLEDGE
EQUIPMENT
PATIENT AND FAMILY EDUCATION
Rationale: This explanation provides information and decreases anxiety.
Rationale: This explanation ensures patient cooperation and facilitates safe removal of the catheter.Related posts:
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68: Central Venous Catheter Removal
