Canterbury DHB

Context

Catheter Removal

This can be performed on the Bone Marrow Transplant Unit or in the Day Ward, though if problematic, prolonged or deep dissection is required, surgical referral will be necessary. In the first instance, removal will be attempted by the Haematology Registrar. He/she will initially tug the line, and/or cut down as deemed necessary. If unsuccessful, refer to the on-call Surgical Registrar.

Surgical referral may also be necessary to avoid unsightly scars (e.g. misplaced lines in women). General anaesthetic may be necessary if patient very anxious.

In This Section

Before Procedure

Removal of Catheter

Before Procedure

Removal of Catheter

There is one fibrous cuff, 7 mm long and located just inside the exit site. Feel the catheter and try to palpate the cuff. Inject local anaesthetic (with adrenaline) around the cuff. Sometimes with a catheter that has been recently placed the cuff may not be embedded in the tissue. In these cases, the catheter may be removed by simple traction.

The catheter tip should be sent for culture if there is a clinical indication such as fever.

If the cuff is located too far from the exit site to be reached from there by blunt dissection, make an incision along the line of the catheter, over the cuff. Use blunt dissection to locate the catheter and cuff. Clamp the catheter above the cuff and separate cuff from surrounding tissue.

This may require gentle use of the scalpel. If necessary, cut through the catheter below the cuff and pull the distal catheter out through the exit site. Take hold of the clamp and gently pull the proximal catheter while applying pressure to the site where the catheter enters the vein. Suture the wound. Apply a sandbag if oozing continues.

At the end of the procedure, place sharps into sharps bin and removal pack equipment into the ‘blue bin’ in the sluice room for return to sterile services for replacement.

About this Canterbury DHB document (5043):

Document Owner:

Sean Macpherson (see Who's Who)

Issue Date:

January 2019

Next Review:

January 2022

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5043