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Removal of Non-Tunneled Central CathetersSMH IP 2033
By Brenda J. John, MSN, MS-HSA, RNNurse Manager, IVR/Cath Lab/EP/Device
Objectives
The learner will be able to state the new process for the safe removal of non-tunneled central catheters at SMH.
Removal of Non-Tunneled Central Catheters - SMH IP 2033
Before Catheter is Removed…
A documented Physician’s Order must be verified in the medical record requesting removal of the line
The lines may be removed by: a house intensivist, surgeon, nephrologists, or a nurse that has demonstrated competency in removing central lines.
*Note: A physician or radiologist must always perform the removal of a Cuffed Tunneled Catheter.
Removal of Non-Tunneled Central Catheters - SMH IP 2033Identifying Non-Tunneled V. Tunneled Catheters Non-tunneled Catheters: external catheters that
extend beyond the skin directly from point of venous access.
Tunneled Catheters: Can be Palpated beneath the skin and tracked to point of venous access. May or may not have external catheter(i.e.Port)
Removal of Non-Tunneled Central Catheters - SMH IP 2033
Common NON-TUNNELED Catheters at SMH:
Temporary Dialysis Catheter (a.k.a. Trialysis Catheter)
Peripherally InsertedCentral Catheter
Central Venous Catheter
Removal of Non-Tunneled Central Catheters - SMH IP 2033
Common TUNNELED Catheters at SMH: (REMOVED BY MD ONLY!!)
Tunneled Dialysis Catheter
Port-A-Cath
Tunneled Hickman Catheter
Removal of Non-Tunneled Central Catheters - SMH IP 2033
Temporary Dialysis Catheters (a.k.a Trialysis Catheters)
Call IVR to the have PICC Nurse remove the catheter, Monday through Friday, 8am to 3pm
After 3pm, Holidays, and Weekends, call the House Nursing Supervisor to remove the catheter
Removal of Non-Tunneled Central Catheters - SMH IP 2033
Peripherally Inserted Central Catheters (PICC Lines)
&
Central Venous Catheters (CVC Lines) Line removal procedure per Mosby’s Nursing Skills: “Central
Venous Catheter: Removal” All units are responsible for the removal of their floor’s lines Floors are to ensure adequate coverage during day and night
shifts, weekends, and holidays COMPETENCY of RNs will be ensured by the respective
department’s Clinician Department Leaders to also receive training for unit coverage
Summary Obtain Physician Order for Line Removal Verify Line is NON-TUNNELED Catheter Temporary Dialysis Catheter Removal◦ Mon-Fri 8am to 3pm – by PICC RN Contact IVR @ 28045
◦ After 3pm, Holidays, & Weekends – by House Supervisor Contact House RN Supervisor @ 76294
PICC & CVC Removal◦ 24/7 coverage by Competent department RN Line removal procedure per Mosby’s Nursing Skills: “Central
Venous Catheter: Removal”
References
Kalender, N., & Tosun, N. (2015). Nursing Studies about Central Venous Catheter Care: A Literature Review and Recommendations for Clinical Practice. International Journal Of Caring Sciences, 8(2), 461-477 17p.
Khan, H., & Zaidi, A. (2013). Paradoxical air embolism following central venous catheter removal. BMJ Case Reports, 1-3 3p. doi:10.1136/bcr-2013-200630
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