When removing a CVC or PICC line,is it your practice to apply manual pressure using plain gauze or do you apply some form of ointment to the gauze first then hold pressure?
I understand the rationale for the application of a petroleum-based product when applying the final dressing. The question is what you first use to hold pressure.
Thanks.
for the holding pressure we use a dry gauze, then ungt for final dressing.
for prevention of air embolism when lifting up the dry gauze or assessing for further bleeding we have patient perform valsalva , and then re apply pressure or apply ungt dressing.
Gina Ward R.N.
Gina Ward R.N., VA-BC
Gina-
Thanks for the response. That's how I've always done it as well,but there is a (proposed) change to our policy/procedure which says to apply the ointment to the gauze you're using to hold pressure. Maybe my imagination is running wild,but I can just envision someone putting a big dollop of Bacitracin or Vaseline on a 4X4 and squeezing the goo into the insertion hole/tract/vein. Having had a patient a few years back with a collagen embolism from Vasoseal,it just seemed 'iffy' to hold pressure with a gooed-up gauze.
Vasoseal is delivered directly to the arterial surface hence higher risk. The distance between the skin and the veinotomy is likely too far to have a ointment emboli. Pulling with a dry gauze is asking for trouble. I believe the guidelines recommend bacitracin, vaseline gauze or hemostatic powders.