removal central line

[kiki1991]

Hi, I removed a CVD for the first time. My supervisor was present in the beginning. First I used a sterile gauze for pressure (for about 8 minutes?). But the gauze was so bloody that I used another gauze for the last 5 minutes, but this was a non-sterile one!! I'm really worried that the patient will have an infection.. but my supervisor says not to worry. What do you think?

Also, I know a complication of removing a CVD is an air embolism. How long does it take for symptoms to occur? And is it true that small air embolisms are normally absorbed with no harm? Thanks!!!

[kiki1991]

"I appreciate your concerns about possible infection. But honestly you need to "get over it". Your situation was not an emergency, however any urgent situation (after the ABC's), stopping blood loss if the next step. Whatever can be quickly grabbed, a shirt, some tissue, a dish rag, etc., even un-sterile gauze, is used."

Thanks, you're absolutely true. It's only that the patient is using immunosuppression med which made me a bit concerned

[kiki1991]

As a thought, next time you do a skill for the first time, see if you can get an educator or a more experienced nurse to do the skill with you. Not only are they support who can guide you with your questions during the procedure, but can lose grab you extra supplies if need be

Good advice, thanks!

[Mavrick, BSN, RN]

We live in a world full of germs/bacteria.

A sterile gauze is only "sterile" for a microsecond. The instant you open the package it becomes exposed to our world full of germs and is no longer sterile. When you place this now non-sterile gauze on a patient's skin you are contaminating it further with the patient's own bacteria.

Our immune system is the best protection against infection. Even immunocompromised people live with their own germs and do a dang good job for the most part. They can still get an infection but that may have nothing to do with your gauze choice. More likely leftover bacteria from the catheter that seeded their system.

As mentioned previously, the open pathway for germs is when the CVC is in place.

The blood clot that forms to keep blood from getting out, also prevents air and germs from getting in.

[brownbook]

(1) If the bleeding hasn't stopped, don't remove the bloody gauze, jut keep holding pressure and put extra gauze on top. If a clot is forming, you don't want to pull it off.

This is the best reply, I wasn't thinking or didn't read the post well enough.

[kiki1991]

(1) If the bleeding hasn't stopped, don't remove the bloody gauze, jut keep holding pressure and put extra gauze on top. If a clot is forming, you don't want to pull it off.

This is the best reply, I wasn't thinking or didn't read the post well enough.

@brownbook so you think your reply isn't valid anymore?

[kiki1991]

(1) If the bleeding hasn't stopped, don't remove the bloody gauze, jut keep holding pressure and put extra gauze on top. If a clot is forming, you don't want to pull it off.

Good advice, this didn't happen to this patient as bleeding already stopped. But I just wanted to make sure and then held pressure for another few minutes with the non-sterile gauze.