Ensure that patient and health care provider safety standards are met during this procedure including:

  • Risk assessment and appropriate PPE
  • 4 Moments of Hand Hygiene
  • Procedural Safety Pause is performed
  • Two patient identification
  • Safe patient handling practices
  • Biomedical waste disposal policies


  1. Apply Related Procedures and Policies
  2. Prepare Dressing Tray
  3. Confirm Balloon Deflation/Prepare Cathter
  4. Evaluate and Stop Infusions
  5. Remove Dressing
  6. Cleanse Site
  7. Unlock Sleeve
  8. Prepare for Removal
  9. Remove Catheter
  10. Post Removal
  11. Document

This procedure is for use by RNs in CCTC who are approved to remove pulmonary artery catheters.

RNs are not approved to remove a Swan Ganz(TM) Paceport pulmonary artery catheter IF a temporary pacing wire is in place.  RNs are not approved to remove the Paceport(TM) temporary pacemaker wire (Chandler Probe)(TM).

 Patients must be connected to Continuous ECG monitoring during removal.  Removal should be performed in a location where a Cardiac Arrest Cart is available in case of persistent arrhythmia (rare, most arrhythmias resolve once catheter is out).

If the Introducer is also to be removed, the pulmonary artery catheter should be removed first and an obturator inserted into the introducer to prevent air or contamination. The introducer should be removed separately according to the Procedure for Removal of a Central Venous Catheter.  



Apply Related Procedures and Policies

Confirm order.

Follow LHSC policies for hand hygiene and infection control before, during and after procedure. Perform hand hygiene and don a mask with eye shield and non-sterile gloves prior to blood sampling.


Prepare Dressing Tray

Perform hand hygiene and open central line dressing change tray.

Don non-sterile gown, gloves, bouffant and mask with face shield.

Perform hand hygiene and prepare dressing tray aseptically using transfer forceps to add supplies.

  1. Open chlorhexidine swabstick and partially remove swabstick with transfer forcep.
  2. Open obturator and transfer to tray.


Image 1

Image 1:  Obturator and cap that is used to occlude the introducer once the pulmonary artery (or CVC catheter) is removed.


Confirm Balloon Deflation and Prepare Catheter

  1. Confirm that the balloon is deflated and in the unlocked position.
  2. Confirm a PA waveform from the tip of the catheter prior to starting
  3. Remove any tape or anchors on the sleeve that would impeded smooth removal.
  4. Unlock the Twist Lock Adapter(TM) that is located at the end of the sleeve farthest from the introducer
  5. Gently withdraw 0.5 cm of catheter to ensure that the adapter is unlocked and catheter will move freely

Removal should be a steady withdrawal. Catheter restriction could result in the catheter tip resting in the ventricle (with ventricular ectope) while impedence is removed.


Image 2


Image 2:  Unlock Twist Lock Adapter(TM)


Evaluate and Stop Infusions

Ensure that all infusions have been relocated. Vasoactive medications should be moved to the introducer (or another central venous catheter if in place).

Turn off all infusions to the poximal injectate or proximal infusion ports (blue, white or orange).

Turn the stopcock to the CVP off but leave PA pressure circuit on to display pressure at tip of catheter.

Upon removal of the PA, all infusion into the white, blue or yellow port will be stopped.  Infusions into the intorducer will be unaffected.



Remove Dressing

Remove the old dressing wearing non-sterile gloves and discard. 

Use a CHG swabstick with a shoveling technique to loosen the CHG pad. 

Scrub the insertion site per standard procedure and allow 2 minute dry time. (Procedure for Central Line Dressing Change).

Discard dressing appropriately and perform hand hygiene.

Sterile technique is maintained to prevent introduction of bacteria into introducer.

The dressing will need to be removed and replaced to access the connection to the introducer.


Cleanse Site

Don sterile gloves.

Scrub the locking cap vigorously and allow minimum 2 minute dry time.


Unlock the Sleeve from Introducer

Turn the locking device end of the sleeve until the cap is loose and can be disconnected easily. 

The sleeve must be disconnected before removal of the pulmonary artery catheter.


Image 3

Image 3: Sleeve in unlocked position


Prepare for Removal

Slide the entire locking device and sleeve back to full expose several inches of pulmonary artery catheter.

Cleanse catheter at insertion point to introducer and allow to dry.

The catheter will be removed from the introducer independent from the sleeve to avoid having catheter withdrawal impeded. Do not attempt to withdraw within the sleeve during removal.


Remove Pulmonary Artery Catheter

  1. Place the obturator within ease of reach. 
  2. Reconfirm balloon deflation, then grasp the pulmonary artery catheter close to the entry point into the introducer. Pull back 5 cm to assess ease of withdrawal. Stop if any resistance is met. 
  3. While observing the ECG, steadily withdraw the catheter with your dominant hand, while securing the introducer with your non-dominant hand. Avoid delaying removal when tip is in the right ventricle.
  4. Continue until there is 5-10 cm of catheter remaining inside the introducer, then pause.
  5. Remove the final segment of the catheter and quickly apply the obturator cap as soon as removal is completed.

Post Removal

If introducer is being removed, use Procedure for Removal of a Temporary Central Venous Catheter.  

Complete dressing change as per Procedure for Central Line Dressing Change.



Document procedure and follow-up assessment in clinical record.



Developed: November 30, 2000 (Morgan, B)

Reviewed: March 29, 2010

Revised: February 27, 2017; Reviewed January 29, 2020


Brenda Morgan

Clinical Nurse Specialist