Vascular Access Removal Procedures PDF

## Removal of Tunneled CVADs and Implanted Ports - Removed by qualified clinicians who have demonstrated competency. Determined by professional Scope of Practice. - Patient should be in flat (supine) or slight Trendelenburg position, unless contraindicated. ### Removal procedure- Midlines - R...

## Removal of Tunneled CVADs and Implanted Ports - Removed by qualified clinicians who have demonstrated competency. Determined by professional Scope of Practice. - Patient should be in flat (supine) or slight Trendelenburg position, unless contraindicated. ### Removal procedure- Midlines - Remove catheter gently and slowly, if resistance is met, do not pull against resistance. - Procedure and key points are the same as removing a non-tunneled CVAD ### Removal PIVs - Replace a PIV inserted in any site other than the upper extremities (feet, leg, breast, abdomen) in an adult as soon as possible - Replacement of PIVs are recommended to be performed when clinically indicated - Remove when no longer necessary for treatment, when not in use for 24 hours or for signs/symptoms of complication (e.g., phlebitis, extravasation, pain, leaking, or dysfunctional catheter) ### Documentation of removal - Catheter site/location - Site condition - Catheter length (CVADs) - Catheter condition - Any difficulties removing catheter; interventions used and patient response - Dressings applied ## Pediatric Considerations - Replace peripheral catheters in children only when clinically indicated. ## Non-Acute Care Considerations - Ensure the patient and caregiver has received and understood education regarding home care for VADs (i.e., daily site assessment, aseptic technique, flushing protocol, and signs/symptoms that require seeking prompt and/or emergency medical attention. - Education provided and patient and caregiver response should be documented in the medical record, including teach-back of catheter care to be performed at home. - Short peripheral catheters should be removed prior to discharge from the infusion center unless a LIP order indicates it may be left in place for subsequent infusions (i.e., a 3-day course of corticosteroids in a patient with difficult venous access). - When any VAD is removed, the patient and caregiver should receive education regarding signs/symptoms of complications related to removed device (post-infusion phlebitis, fever, drainage from site, etc) and how to manage those complications. - Following removal of non-tunneled CVAD, educate the patient and caregiver regarding importance of keeping air-occlusive dressing in place for 24 hours, reapplying new dressing daily until site appears well healed.