|
Procedure
|
|
Rationale |
| 1. |
Ensure
that catheter balloon is deflated. |
1. |
To
protect against valve damage during removal. |
| 2. |
Turn
off all pulmonary artery catheter infusions including flush device for
PA lumen. |
2. |
To
prevent leakage after catheter removal. |
| 3. |
Disconnect
the catheter sleeve from the introducer connector. The yellow pulmonary
artery catheter should now be accessible at the entrance to the introducer
lumen. |
3. |
Disconnection
of the sleeve permits unimpeded catheter removal. |
| 4. |
Hand hygiene and don sterile
gloves, grasp the exposed pulmonary artery catheter. |
4. |
The
catheter is accessible once the sleeve has been disconnected. Gloves
will protect the nurse from exposure to body fluids. |
| 5. |
Remove
catheter in one smooth and steady motion. Avoid prolonged passage
through the right ventricle. Observe ECG monitor for arrhythmia development.
If
resistance is met, discontinue procedure and contact the physician immediately. |
5. |
A
catheter tip in the right ventricle can precipitate ventricular ectopy. |
| 6. |
If
ordered, cut the end of the catheter with sterile scissors and send to
the lab in sterile container for culture and sensitivity. |
6. |
Culture
may be requested if bacteremia is suspected. |
| 7. |
Loop
the pulmonary artery catheter into a small coil. Turn glove inside
out during glove removal, wrapping the pulmonary artery catheter inside. |
7. |
Containment
of the pulmonary artery catheter within the removed glove protects health
care workers from exposure to body fluids. |
| 8. |
Immediately
insert obturator cap into introducer lumen, unless immediate introducer
removal is planned. If a long introducer lumen is used, use sterile gloves
and a dressing tray to maintain control of obturator during insertion
To
remove the introducer, proceed as per Procedure
for Removal of Central Venous Catheters.
Remove sterile gloves and perform hand hygiene.
|
8. |
The
obturator cap protects against potential air or pathogen entry into the
catheter. The obturator also maintains introducer sterility, allowing
the insertion of a multilumen catheter if desired.
The
long obturators are floppy; during insertion, they are prone to folding
which can result in obturator contamination. Sterile gloves permit
more control over the obturator during insertion.
In accordance with the MoHLTC 4 moments of hand hygiene and LHSC infection control policies in an effort to reduce risk of transmission of microorganisms and secretions |
| 9. |
Document
removal in AI record (CCTC), Kardex, graphic record (flowsheet) and vascular
line tracking record (UC). |
9. |
To
communicate discontinuation of catheter. |
Print
Handheld
Contrast
