Removal of Central Venous Line

Charity, RN, APRN · Feb 17, 2006

When I first started in Peds (has it been 15 years already??!) I had a surgeon ask if I could dc the patient's central line. This was on the floor. Of course, I said. He was so surprised. Apparently, many of the nurses in that facility had the docs convinced that nurses could not dc central lines, because they were either unused to the procedure or too busy doing other things!

Care of CVCs is included in the basic orientation packet/skills checklist. This care includes discontinuation of central lines, PICCs included. It is a little more complicated when it comes to pulling PA lines--

Pediatric Critical Care Columnist · Feb 19, 2006

We remove all CVCs and arterial lines, the vast majority of which are sutured in place, in our unit. In the three plus years I've worked in this particular unit, we've only had one patient with a PA catheter, and it, along with all intracardiac lines, was d/c's by a physician. The few PICCs we have are d/c'd by our advanced-practice nurse practitioner.

megcaffrey · Feb 20, 2006

Thank you so much for your replies. Janfrn- do you have a competency or policy for pulling CVC lines in your hospital?

Pediatric Critical Care Columnist · Feb 20, 2006

Whoa!! I have a copy of the our orientation materials at home! Who knew? It says "RNs may remove once observed by Clinical Nurse Educator or designate as per... (policy). PEDIATRICS - designated individuals only." So I guess it Is a competency.This of course only refers to non-tunneled short term catheters. When I go to work tonight, I will try to get at the policy and procedure manual and get you the real goods.

megcaffrey · Feb 20, 2006

Janfrn- you are wonderul! Thanks a million!! :nurse:

Pediatric Critical Care Columnist · Feb 21, 2006

Of course last night got away from me and I found myself pulling up our P&P on the computer after my shift was over. I unfortunately didn't read the document I e-mailed myself to email to you all the way to the end, and sad to say, it only deals with PICCs. I'm PMing you that one anyway and when I go back to work on the weekend I'll get you the rest. This time I'll read it... :rolleyes:

pedinurse05 · Mar 21, 2006

We remove cvl's and PICC's on our intermediate ICU floor. We just get checked of by a preceptor. If they are sutured we just remove the sutures, remove the line, apply a pressure dressing, and monitor for any bleeding. Always note the integrity of the tip in your charting as well. Other places I have worked required an IV/PICC nurse to remove CVL's--but here at the large University hospital, we do it. I think the policy varies from place to place.

jenpicuRN · Apr 20, 2006

At my hospital, only PICU RNs can remove CVLs and ALines. if a kid is on the floor with a CVL we are called to remove it.

Pediatric Critical Care Columnist · May 30, 2006

Meg, did you ever get the P&Ps I sent you? Just checking...