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•
Establish and maintain catheter patency by:
• flushing intermittently via syringe with heparinized saline
or preservative-free 0.9% sodium chloride
• continuous drip
• positive pressure device
•
Amount of heparin depends on:
• physician preference,
• hospital/institutional protocol,
• patient condition
Caution:
Assess patient for heparin sensitivity. Heparin-Induced
Thrombocytopenia (HIT) has been reported with use of
heparin flush solutions.
•
Volume of flush solution should be:
• equal to at least twice the priming volume of the catheter
and any add-on devices
NOTE: Catheter priming volume is printed on product packaging.
Warning:
Open catheter clamp prior to infusion through lumen to
reduce risk of damage to extension line from excessive
pressure.
•
Properly flush (heparinization) using a positive-pressure flushing
technique to help prevent occlusion, when using any VAD for
intermittent infusion therapy.
NOTE: Neutral as well as positive displacement valve systems have also been shown
to help prevent occlusion.
•
Properly cleanse all valves with an appropriate antiseptic before
being accessed.
•
The SASH or SAS method of flushing will help eliminate
occlusions due to incompatible solutions:
• Saline • Administer drug • Saline • Heparin (if used)
Catheter Removal Instructions
1. Perform catheter removal:
• following order of authorized prescriber
• in accordance with hospital/institutional policies, procedures,
and practice guidelines
2. Remove catheter immediately upon patient assessment for:
• suspected contamination i.e. when catheters are inserted
during a medical emergency or if adherence to aseptic
technique cannot be ensured
• unresolved complication(s)
• discontinuation of therapy
• source of infection
Caution:
Do not use guidewire techniques to replace catheters in
patient suspected of having catheter-related infection.
3. Place patient in supine position, as clinically indicated to reduce
risk of potential air embolism.
4. Remove dressing.
Warning:
Do not use scissors to remove dressing, to reduce risk of
cutting catheter.
5. Remove sutures or staples; or open catheter stabilization device
retainer wings and remove catheter from catheter stabilization
device posts.
6. Place gauze pad over insertion site and catheter.
7. Remove catheter by slowly pulling it parallel to skin. If resistance
is met while removing, catheter should not be forcibly removed
and physician should be notified.
Caution:
Do not exert excessive force while removing catheter, to
reduce risk of catheter breakage.
8. Upon removal of catheter:
• inspect for intact Blue FlexTip® or catheter tip
• ensure entire catheter length has been removed
9. Apply direct pressure to site until hemostasis is achieved.
10. Apply alcohol swab to catheter stabilization device adhesive and
gently lift pad off of skin (if applicable).
11. Dress insertion site. Apply sterile air occlusive dressing and assess
site every 24 hours until site is epithelialized.
Warning:
Residual catheter track remains an air entry point until
completely sealed, occlusive dressing should remain in
place for at least 24 - 72 hours dependent upon amount of
time catheter was indwelling.
12. Document catheter removal procedure on patient's chart per
hospital/institutional protocol.
Include:
• catheter condition
• length of catheter removed/presence of intact catheter tip
• patient's tolerance of the procedure
• any interventions needed for removal
For reference literature concerning patient assessment,
clinician education, insertion techniques and potential
complications associated with this procedure refer to Arrow
International, Inc. website: www.arrowintl.com
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