removing a peripheral IV catheter in adults
postprocedural steps for removing peripheral IV catheter
Follow standard post procedure steps (in detail below), as appropriate. Monitor PIV site for 48 hours post removal to assess for hematoma formation, post infusion phlebitis, and other complications. Facilitate a culture of exudate if ordered and if evidence of an infection is present. Hold pressure on PIV site for additional time to achieve hemostasis for patients who are receiving anticoagulants
standard post procedure steps for removing peripheral IV catheter
Maintain patient safety. For example, position for safety, verify alarms are audible, verify call light is in easy reach, and follow facility protocol for fall prevention. Remove and discard used personal protective equipment and other used materials in proper receptacles. Clean equipment if there has been patient contact. See specific manufacturer instructions. Perform hand hygiene.
procedure supplies to remove peripheral IV catheter
nonsterile gloves and PPE equipment sterile gauze antiseptic wipe adhesive remover tape facility approved pain assessment tool
client and family education for removing peripheral IV catheter
Educate patient/family about what to expect during and after procedure. Encourage and answer any questions. Instruct patient to immediately report pain or tenderness at the PIV site, swelling, redness, or drainage.
documentation for removing a peripheral IV catheter
Date/time of PIV removal, along with reason for removal Whether the catheter was removed intact Patient assessment information, including vital signs, pain level, patient response to procedure, and any evidence of complications noted Any medications administered Any unexpected patient events or outcomes, interventions performed, and whether or not the treating clinician was notified Patient/family education, including topics presented, response to education provided/discussed, plan for follow-up education, and details regarding any barriers to communication and/or techniques that promoted successful communication
standard preprocedural steps for removing peripheral IV catheter
Introduce yourself to patient/family. Identify patient using at least 2 unique identifiers (such as full name, date of birth, or medical ID number). Identify and address any special communication needs patient/family may have. Identify and accommodate, if possible, any specific cultural and religious beliefs that may enhance care. Be aware of any assumptions you may have to minimize bias. Ask patient if they would prefer a clinician of a certain gender if procedure involves steps that possibly compromise dignity/privacy. Meet request, if possible. Provide privacy for patient. Explain procedure. Verify completion of informed consent documents, if appropriate. Verify supplies are in good working order and review manufacturer instructions for use. Perform hand hygiene. Use personal protective equipment and appropriate aseptic technique.
care consideration for removing a peripheral IV catheter
PIVs are removed based on clinical indications and condition of the catheter insertion site, unless facility protocol requires routine replacement. PIV should be removed as soon as the catheter is no longer clinically indicated, if not used in 24 hours, or if complications (such as phlebitis or infiltration) are noted
client outcomes for removing a peripheral IV catheter
The patient will experience minimal pain throughout the procedure and no complications. PIV will be removed intact.
procedure steps for removing a peripheral IV catheter
adjust clients bed to a comfortable working height and assist client to a sitting or recumbent position assess PIV insertion site for signs/symptoms of complications such as pain, swelling, or erythema contract treating clinician if any complications are suspected administer any prescribed medications disconnect any attached admin sets trace admin set tubing from PIV to infusion source to ensure your working with correct line turn off infusion pump clamp tubing disconnect admin set from PIV and set it aside use standard aseptic non-touch technique (ANTT) to prepare supplies open gauze, adhesive remover, and antiseptic wipe packages assemble in general aseptic field clean work area put on clean gloves and carefully remove dressing and tape stabilize catheter at all times pull back dressing/tape edges toward direction of insertion site to avoid injuring vein do not apply pressure over PIV during removal, which can cause client discomfort use adhesive remover or an antiseptic wipe to assist in removal if necessary remove catheter securement device place gauze above PIV insertion site slowly withdraw catheter, ensuring hub of catheter remains parallel to skin use gauze and apply pressure over the insertion site until bleeding stops apply sufficient pressure to reduce the formation of a hematoma apply a clean gauze pad to PIV insertion site secure gauze with bandage tape assess integrity of catheter ensuring it remains intact and entire length of catheter has been removed contact clinician immediately if catheter is broken or fractured and consider placing a tourniquet above IV site dispose of catheter in appropriate container according to facility policy
what you need to know before removing a peripheral IV catheter
anatomy of the venous system particularly the veins that are commonly used for PIV placement in adult and older pediatric clients PIVs are typically placed in the superficial veins of the upper extremities for ped clients in addition to the veins used for adults the greater saphenous vein in the leg can also be used for neonates the superficial scalp veins or the dorsal veins of the foot are frequently used signs and symptoms of PIV associated complications (phlebitis, infection including PIV associated BSI (CRBSI)- fever, chills, unexplained hypotension), infiltration and extravasation, embolism CRSBI diagnosis requires a positive blood culture from a peripheral vein INS recommends clinically indicated removal as soon as it is no longer included in the treatment plan or has not been utilized for more than 24hr time criteria schedule for PIV removal- no more frequently than every 72-96hr in order to prevent PIV associated infections
red flags for removing a peripheral IV catheter in adults
remove PIV when clinically indicated and not routinely inspect removed catheter for fracture, if catheter is not removed intact, immobilize limb and contact treating clinician asap place a tourniquet high above insertion site to reduce risk of embolus entering systemic circulation to prevent risk of bleeding always check clients coagulation studies prior to removing PIV, discuss any abnormal values with treating clinician
preprocedure steps for removing a peripheral IV catheter
review facility/unit specific protocols for PIV removal review treating clinicians order for PIV removal review instructions for all equipment to be used and verify equipment's is in good working order review clients medical history/medical record for indications for PIV removal, any allergies, use of mediations and lab test results that could affect hemostasis following removal, check with treating clinician prior to removal if any coagulation abnormalities are noted
preliminary steps to perform prior to removing a PIV catheter
review the facility/unit specific protocols for PIV removal review the treating clinicians order for discontinuing IV therapy or IV medications or for PIV removal review the instructions for all equipment's to be used and verify that equipment is in good working order verify completion of facility informed consent documents review the clients medical record for indication for PIV removal, any allergies, use of medications or lab tests results that could affect hemostasis following removal check with treating clinician prior to removal if any coagulation abnormalities are noted gather supplies and equipment necessary to remove the PIV
purpose of removing an peripheral IV catheter
to remove it at the appropriate time, intact with minimal discomfort and to keep the client free from infection or other complications
