Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

347

Skill Checklists for Taylor's Clinical Nursing Skills:
A Nursing Process Approach, 3rd edition

Name Date

Unit Position

Instructor/Evaluator: Position

SKILL 16-4

Removing Arterial and Femoral Lines

Goal:The line is removed intact and without injury to the patient. Comments

1. Verify the order for removal of arterial or femoral line in
   the patient’s medical record.


2. Gather all equipment and bring to bedside.


3. Perform hand hygiene and put on PPE, if indicated.


4. Identify the patient.


5. Close curtains around bed and close the door to the room,
   if possible. Explain the procedure to the patient.


6. Ask the patient to empty his or her bladder. Maintain an IV
   infusion of normal saline via another venous access during
   the procedure, as per medical orders or facility guidelines.


7. If the bed is adjustable, raise it to a comfortable working
   height, usually elbow height of the caregiver (VISN 8
   Patient Safety Center, 2009).


8. Put on clean gloves, goggles, and gown.


9. If the line being removed is in a femoral site, use Doppler
   ultrasound to locate femoral artery 1 to 2 inches above the
   entrance site of the femoral line. Mark with ‘X’ using
   indelible pen.


10. Turn off the monitor alarms and then turn off the flow
    clamp to the flush solution. Carefully remove the dressing
    over the insertion site. Remove any sutures using the suture
    removal kit; make sure all sutures have been removed.
    11.Withdraw the catheter using a gentle, steady motion. Keep
    the catheter parallel to the blood vessel during withdrawal.
    Watch for hematoma formation during catheter removal
    by gently palpating surrounding tissue. If hematoma starts
    to form, reposition your hands until optimal pressure is
    obtained to prevent further leakage of blood.
    12.Immediately after withdrawing the catheter, apply pressure
    1 or 2 inches above the site at the previously marked spot
    with a sterile 4 4 gauze pad. Maintain pressure for at
    least 10 minutes, or per facility policy (longer if bleeding
    or oozing persists).Apply additional pressure to a femoral
    site or if the patient has coagulopathy or is receiving
    anticoagulants.

Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

ExcellentSatisfactoryNeeds Practice