EJ Discontinuation Question

[gtmoore]

Are floor/tele nurses at your facility allowed to d/c EJs, or does it have to be someone on your IVT team? My first thought was that it is considered a peripheral line so the same considerations apply as to other peripheral lines. As a tele nurse at our facility, we are allowed to d/c IJs and other central lines (with the exception of PICCs), so why would we not be allowed to d/c an EJ? Any thoughts?

[GM2RN]

I've never done it, but it occurs to me that it might depend on your hospital's policy. I'd check with them first.

[nurse2033, MSN, RN]

It may have been overlooked and not specifically mentioned because they are not that common. If you see a lot of them I'd be curious as to why. But, yes, I believe they are no different to remove than a peripheral.

[IVRUS, BSN, RN]

Are floor/tele nurses at your facility allowed to d/c EJs, or does it have to be someone on your IVT team? My first thought was that it is considered a peripheral line so the same considerations apply as to other peripheral lines. As a tele nurse at our facility, we are allowed to d/c IJs and other central lines (with the exception of PICCs), so why would we not be allowed to d/c an EJ? Any thoughts?

What a strange policy that is... I say that because you stated that you were allowed to discontinue an internal jugular line and other central lines, but that you weren't able to d/c a PICC???? Well, knowing that a PICC is a central line too, what is their rationale? Are they afraid that you will not realize when it is resistant to removal and that you may pull to hard and the catheter may sever and embolize?

Removing a PICC carries less of a liability than other central lines as it relates to Air Embolism, and given the compressibility of the site (especially the ACF) you definitely can impede bleeding better than those in the subclavian area.

Perhaps the answer lies in the fact that your IV team wants to keep their monitoring of these lines ongoing.

External Jugular catheters are in a smaller and more tortuous vessel, albeit more superficial. EMT's often receive training on placement of short term, less than 3" IV catheters in this vessel. If you are discontinuing a short term peripheral in this spot (and it should be d/c'd within 24 hours) you should be able to do it using the same precautions as others.

Hopes this helps.