I hate to sound too desperate, but we have our (very pushy) interventionalist saying that nursing can remove the Hohn catheters at the bedside.......and have had a couple of responses saying that their nurses are not allowed to remove them at the bedside.Â
Is there a publication that addresses this issue?
I need to get a policy in place asap and I don't know how to proceed. I don't want to wait until we have a disaster before I write the appropriate care into policy. I also don't want to be sending all of these to IR for removal if that is unnecessary.Â
Is it possible to treat them like PICCs and have the nurses remove unless there is resistance? I really prefer not to do it that way because once the catheter is partially loosened it seems there would be risk of an air embolus.
I have the manufacturer's IFU and they say nothing about care/removal.Â
I really need to know what the rest of you are doing re removal of these catheters.
Please respond......and thanks for your help!
Alma Kooistra RN, CRNIÂ
Of the four placed this week, three are subclavian and one is IJ.
I know these catheters have been around for a long time, but they're new to us. Personally, I think I'd feel comfortable giving the thing a tug and if it won't budge easily, I'd call IR or some other resource to come and remove it. My main concern is our staff nurses who will be the ones doing removal of these lines if we do it at the bedside. They're accustomed to removing subclavians and IJs, but this line is new to them and I don't want to put them in a potentially difficult situation.
Are the Hohns a commonly used device, and am I crazy to worry about this so much?
Thanks!
Alma Kooistra RN, CRNI
I have removed one Hohn catheter at the bedside. It was placed in the subclavian and it came out just like a standard triple lumen central line, no resistence, cuff intact. It was fairly simple.
However, I have only seen two Hohn catheters in the past two years so I don't have any more additional info for you other than it did seem like a safe and reasonable nursing task at the time.
Alma, send me your fax number. I will send a copy of this correspondance to you in case that will help you regarding removal; these are the questions I also asked and were answered by Bard directly via their e-mail. My e-mail is [email protected]. Actually, maybe I'll scan these and send back via e-mail for a cleaner print for you.
Carole
Robbin George RN VA-BC