Hi
We are updating our policies, one of which is removal of non-tunneled CVC's. Our policy states to open a sterile central line dressing kit, clean the area like when changing the dressing and after removal apply a sterile occlusive pressure dresssing. Does anyone mind sharing their policy?
Thanks
From serving as an expert on several legal cases of catheter associated venous air embolism I can tell you that the issues are:
1. patient's positon during removal
2. length of time the patient is required to remain in that position after removal
3. application of a truly air occlusive dressing
For the position, lying flat is recommended, but the length of time to remain in that position has 3 suggestions from published literature - 10, 30, and 60 minutes. All of these are opinion and not based on research. After all, there is hardly an ethical way to conduct such research in a human. There are animal studies involving the amount of air required to cause harm.
An air occlusive dressing can only be accomplished with a petroleum-based ointment on a gauze that is taped securely on all sides and across the top of the gauze and allowed to remain intact until the site is healed or at least 24 hours.
There is a new standard on this in the Infusion Nursing Standard of Practice that would be helpful. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861