IV Therapy: Withdrawing The Troops

The Centers for Disease Control and Prevention (CDC) guidelines state that a peripheral venous catheter can remain in place for 72 to 96 hours in an adult.  This is dependent on an absence of signs or symptoms of infiltration or phlebitis or concerns about possible contamination.  To be on the safe side, many facilities require you to install a new IV line every 72 days.  Consult your facility’s policy.  Also, if therapy is to continue, it is not recommended to remove venous access until a new access site has been installed and secured.

Removing a peripheral IV line is relatively quick and simple.  Double check the order to discontinue IV infusion before you remove it.  When removing the catheter, remember you are working around a wound that leads directly into the bloodstream, so be sure to follow your facility’s infection-control guidelines.  

First move the roller clamp on the tubing to the closed position.  This avoids spilling IV fluid that is contaminated with the patient’s blood. Next, stabilize the catheter with the thumb of one hand while pulling the transparent dressing and tape toward the insertion site.  Remove these items if possible without moving the catheter as this may cause pain and trauma to the vein.  Next, place a bulky dressing over the insertion point.  While applying pressure to the dressing, slide the catheter out of the extremity.  Do not use an alcohol pad, as this will cause pain when the alcohol enters the open wound.  Alcohol also causes vasodilation and will increase bleeding after the catheter is removed.

Continue to hold pressure on the bulky dressing for several minutes to avoid formation of a hematoma.  When bleeding has stopped, asses the IV site for pain, redness, swelling and drainage.  The presence of these signs and symptoms may indicate infection.  If you suspect an infected site, notify the provider immediately.  You may be directed to obtain a specimen for cultures.  This specimen should be obtained from the insertion site.  You might also cut the tip of the catheter off with sterile scissors.  Place both samples in a sterile container for transport to and analysis by the lab.   

Before discarding the IV catheter, you must inspect the tip to be sure that it is intact. If it is not intact, notify the provider immediately.  A piece of the catheter that may have broken off has the potential to cause an embolism, and may have significant or even lethal consequences for your patient.  Limit the movement of the embolus by applying a tourniquet high on the affected extremity.  Follow your facility’s policy for additional interventions.  

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