Does your facility aspirate blood before removing a sheath?

[ALCCRN]

Does your facility still teach you (or say in the policy) to aspirate 2-3 cc prior to removing a sheath? Or is this old school? I'm leaning toward old school but need some evidence-based practice to back me up...Any suggesstions on what direction to take? And what does your facility do?

[seanpdent, ADN, BSN, MSN, APRN, NP]

Haven't pulled a sheath in a while. It was a matter of preference where I worked. I agree it may have been an 'old skool' protocol?

It wasn't a required protocol.

[mcmars]

We do...a 10ml syringe to be exact.

However, that might be old school as I find our unit does things that aren't exactly based on evidence. But hey, EVP is a transition...you don't get there over night!

[Indy, LPN, LVN]

Where I learned to pull sheaths, they do aspirate but it is in order to check a bedside ACT. You have to waste, then sample, then depending on the result you can flush it with NS and come back for recheck, or not flush it and pull if it's time.

[TLCinCICU]

It's policy where I work that you must aspirate from a sheath before pulling it. The theory is that any clot at the tip could be stripped loose as the sheath is pulled. It (in theory) could then embolize to the lower leg. If we cannot aspirate, we are to have 2 nurses dc the sheath. One is to connect the syringe and maintain negative pressure as the sheath is pulled. This all came directly from one of our senior interventional cardiologists. I'm not sure where he found the evidence to back it up.

[SEOBowhntr]

Not really necessary but it's not going to hurt anything to do it. Having someone keep negative pressure with a syringe while another pulls sounds a bit ludicrous to me. I've pulled a BUNCH of them over the last 13yrs (several as a Student working in a CCU), and various hospitals have various policies, I believe keeping an Arterial transducer and pressure bag w/ 2:1 Heparin should help prevent most "embolic" possibilities, and that MOST places check ACT's except if they've used Angiomax, which is seemingly becoming more common. Certainly not a "bad idea" per se to aspirate a little. I worked with a group of people who one time used to let the site spurt a couple spurts of blood across the room before applied pressure because they thought the the sheath itself may have a "clot" on it, and they wanted to let the body "spurt it out." Now those are some people that need to have a refresher in reducing potential exposures in the workplace.

[ALCCRN]

Thanks for all your replies-Keep them coming!

SEOBowhntr- I have seen facilities do that too...It must be old school!

[SEOBowhntr]

Thanks for all your replies-Keep them coming!

SEOBowhntr- I have seen facilities do that too...It must be old school!

In all honesty, I think it's more likely "Dumb School." I can't imagine what a lot of people are thinking, then there are some I can't imagine are capable of thinking.

[Virgo_RN, BSN, RN]

We don't, and I haven't even heard of the practice until now.

[SusanKathleen, RN]

Here is a URL from Boston Scientific: they say to aspirate.....

http://www.bostonscientific.com/Device.bsci?page=ResourceDetail&navRelId=1000.1003&method=DevDetailHCP&id=10071092&resource_type_category_id=1&resource_type_id=91&pageDisclaimer=Disclaimer.ProductPage

[Virgo_RN, BSN, RN]

It says to aspirate when removing the dilator, probe, or catheter. It does not say to aspirate when removing the sheath itself.

[jmgrn65, RN]

Never heard of aspirating prior to removing the sheath. Most of our policies and procedures are evidence practice I will take a look at them. I haven't pulled sheaths in a couple of years.