IV removal etiquette?

[pa715]

Two questions:

1)how to remove IVs without getting drops of blood on patients?

2) Do you always glove your removed IV and then throw in trash? I just feel like I will stick myself doing that.

[iluvivt, BSN, RN]

All good suggestions but the fact that you may be having a problem tells me that you may not be pulling the tape off well BEFORE you attempt cannula removal. I carefully peel off each side until all the tape is loose then you can have a controlled pull of the cannula.Loosening techniques that have been described are all good. I use skin prep around the insertion site with every start as not only does it protect the skin it makes the dressing removal easier for the patient. I only use a small TSM and then paper tape or hypa fix tape on thin or fragile skin. I do not appreciate it nor do I find the care to be individualized when plastic tape is applied on such skin. I know that is appreciated it when it comes time to discontinue the PIV.

Always pull the cannula out flush with the skin so as not to enlarge the puncture site or damage the vein as both of these can increase bleeding after removal of the cannula.

Elevation of the arm will also slow down the bleeding as well as stopping any continuous infusion a few minutes before you discontinue the cannula. Once in awhile I may use these techniques if I know the patient will most likely bleed a lot and I want to minimize my hold time after discontinuation. You know the type.....pts on Heparin drips with leaky IV sites,pts with very thin skin on Coumadin,pts with low plt counts,pts htat are very bruised,and ACF sites to name a few.

[evolvingrn, BSN, RN]

I don't throw it in the sharps...........that is so expensive.. apply gauze as you pull out the iv...(i always hold pressure for 30 seconds and then ask the pt to continue holding pressure for about a minute.

[sofiamcclain]

I put Dcd iv in a sharp container as well, always put a gauze over an infection site before removing the cath, usually when you remove the iv the leftover blood that might be still in angiocath would be pulled to the tube.( in my case:), so no blood drops:))

[**12XY**]

Ditto, gauze over site as you are withdrawing and hold pressure. And ditto again, there is no needle there, it is plastic only and to thin and pliable to puncture anything.

[studentnurse9806]

So should u apply pressure before u remove the iv and then pull out? Or remove then put pressure?

[sapphire18]

Well you can't apply pressure before you pull it out or else it won't come out. I put pressure as I'm pulling it out/as soon as the IV is out of the skin. I also put them in the sharps- I was just always taught to do that. Same with flush syringes.

[imintrouble, BSN, RN]

1) Gauze over the site while removing the cathlon.

2) Dispose in sharps.

I'm not sure where I learned to throw the used cathlon in sharps. I guess it really doesn't need to be. Must be one of those old school things.

[evolvingrn, BSN, RN]

you should check your policy that is extremely wasteful to put flushes in a sharps container (think about what a sharps container is for), that was what was the norm when i started at my current place which i thought was weird and they had a mass education about a year ago to stop people from doing that because of the expense.

[KelRN215, BSN, RN]

you should check your policy that is extremely wasteful to put flushes in a sharps container (think about what a sharps container is for), that was what was the norm when i started at my current place which i thought was weird and they had a mass education about a year ago to stop people from doing that because of the expense.

When I worked in the hospital, we were told that ALL syringes (including needleless ones- saline flushes, heparin flushes, IV meds, etc) were to be disposed of in the sharps. Their rationale was "the environmental services people will get confused if there are syringes in the trash."

[sapphire18]

When I worked in the hospital, we were told that ALL syringes (including needleless ones- saline flushes, heparin flushes, IV meds, etc) were to be disposed of in the sharps. Their rationale was "the environmental services people will get confused if there are syringes in the trash."

Yeah this. And empty med vials too.

[sapphire18]

Also leaving flushes/syringes around is a no-no bc according to the hospitals I've worked for, people can steal them for drug use. We always have to have them out of the rooms and away from visitors when JCAHO comes.

[IVRUS, BSN, RN]

Always hold a 2x2 or a 4x4 gauze over the insertion site, but do NOT apply any pressure to the site until the IV catheter has been removed. Do not use Alcohol to d/c the line as it burns and promotes bleeding. Do not use a cotton ball to hold at the site as its fibers will stick to your pt's wound once the clotting cascade has been achieved. Also, always pull out the catheter flush with the skin. Do NOT pull out at an angle as this can set your patient up for what is called, "Discontinuated Mechanical Phlebitis" as the tip scraps the smooth Tunica Intima on removal. Pressure should be applied immediately once the ONC has been removed and this pressure should continue till the clotting cascade is complete ~

2-6minutes. Remember this can be upward of 6 minutes secondary to medications/disease processes. Tell the patient if he or she experiences any pain or itching or the gauze pad becomes saturated within the first 24 hours then you need to be contacted. The pad should remain in contact with the skin, and covered with tape for 24 hours. Once the ONC is removed, while one hand is holding pressure, the other should be ascertaining that the same length that went in, came out, and that to the "naked eye" there are no jagged edges. And that is how I'd chart it.