UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES           PROCEDURE:

MEDICAL CENTER                                          EFFECTIVE:    1/08

REVISION:

PROCEDURE                                               APPROVED:    1/08

 

PROCEDURE FOR REMOVAL OF A PULMONARY ARTERY CATHETER

 

(Done by RNs in the intensive care setting and specialty/AP nurses who have completed competency check off)

 

PURPOSE:      To safely remove pulmonary artery catheters.

 

EQUIPMENT:

  1. Physician order for catheter removal

  2. Sterile and non-sterile gloves

  3. Gown

  4. Fluid shield face mask

  5. 4x4 sterile gauze

  6. Central line dressing kit

  7. Moisture-proof absorbent pads

  8. Obturator/cap for hemostasis valve

  9. Suture removal kit

  10. Sterile specimen container (if culture of tip to be obtained)

 

NURSING ACTION:

 

*USING UNIVERSAL PRECAUTIONS*

 

PROCEDURE STEPS:

 

  1. Explain the procedure to the patient/family.

  2. Wash hands.

  3. Place the patient in supine position in slight Trendelenburg position (if Trendeleberg is contraindicated, place supine)

  4. Turn patients head away from the insertion site.  the site should be visible.

  5. Discontinue intravenous solutions or relocate any necessary infusions to an alternate site.  Attach empty syringe to lumen as soon as IV line removed.

  6. Prepare sterile field and open supplies.

  7. Remove syringe from balloon port.  Make sure balloon port is in open position.

  8. Observe PA waveform.

  9. Turn all stopcocks off to the patient.

  10. Unlock catheter from the introducer.

  11. Remove old dressing.

  12. Discard gloves, wash hands, and put on sterile gloves.

  13. Ask the patient to take a deep breath and hold it.

  14. Stabilize the introducer, and gently withdraw the pulmonary artery catheter using a constant steady motion continuously monitoring PA waveform and EKG waveform.

  15. Temporarily cover the introducer opening with a sterile gloved finger until obturator/cap is secured.

  16. If catheter tip is to be cultured, have a colleague assist by cutting 1-2 inches of the catheter tip into a sterile container using the second pair of scissors - NOT the ones used to cut sutures.

  17. Have to patient exhale once the catheter is removed.

  18. Place the pulmonary artery catheter on an absorbent pad.  Make sure the entire catheter was removed.

          a. If catheter tip is not completely recovered:

  19.   If the introducer remains in place, perform site care and apply dressing.

  20.   If the introducer is to be removed follow PROCEDURE 116 for the REMOVAL OF NON TUNNELED CENTRAL VENOUS CATHETERS.

REFERENCES: Lynn-Mchale Wiegand, Debra J., Carlson, Karen K. (2005). AACN Procedure Manual for Critical Care  pp. 570-574. Philadelphia, PA

 

RESOURCE PERSON(S): Shelly Armstrong, RN, BSN, CCRN