Does anyone know of a standard, or do you have a policy, on the replacment of an emergently placed CVC when conditions likely allowed for contamination of the catheter, skin,or catheter hubs at the time of insertion? If so, do you require an over-the-guidewire exchange or a new site? I know there must be much clinical judgement on an individual basis for each patient. Just looking for a general guide if you have one that is official policy or standard.
I am aware INS standards indicate a "peripheral placed in an emergent situation where aseptic technique has been compromised shall be replaced as soon as possible and no later than 48 hours" but have not seen a similar suggestion for CVCs which are of much greater risk.
Thank you for your collaboration!
You can access the CDC Guidelines through this website under Downloads, then select Misc. The CDC, also, clearly recommends changing emrgently placed lines ASAP but no longer than 48 hours. It wouldn't suffice to do a wire exchange because you already suspect contamination. The Guideline also discusses conditions for wire exchange or new site. The most impotant aspect that I don't think we are always good at, is removing ALL lines when no longer medically necessary. We, now, even question placing unecessary lines. I hope this helped
Karen
Karen McKeon Williford RN, CRNI
Thank you Karen. I am reviewing the CDC Guidelines and cannot find the statement. Do you happen to know the page #? Jackie
Does your insitution recommend the use of a Central Line vs. peripheral IV for administration of pressor drugs (dopamine, levophed, etc.),
Does your insitution recommend the use of a Central Line vs. peripheral IV for administration of pressor drugs (dopamine, levophed, etc.),