We are in the process of updating our protocol for CVADS. In the Infusion nursing standard of care it states:
The use of positive pressure during removal of needle withdrawal should be used to reduce blood reflux and risk of thrombotic catheter occlusion.
if we use positive pressure I.e. instill required heparin and clamp during instillation if no cap. Or clamp after removal of syringe if positive pressure cap in place. Is that considered using positive pressure during removal of non coring needle. I have never removed a needle while instilling heparin.
Carolyn Bonanno R N
This is based on the idea that the act of withdrawing the needle from the septum can cause blood to be pulled into the catheter lumen. So flushing inward as you pull out the needle is what is recommended to prevent this. The techniques you described will reduce reflux induced by the syringe design and the needleless connector but would not prevent blood from moving into the catheter as the needle is withdrawn. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I have not come upone that standard. I am focusing on PICCs most of the time.
That recommended technique would almost require a 3rd hand to de access a port.
I usually use one hands fingers to support and apply light pressure to the port/saftey pads that activate the needle covering during withdrawl to protect from needle sticks, while pulling up on the needle with the other hand. Even if you dont have the saftey needle cover to hold on to ,you want to hold on to the port so it doesnt pull as we pull up on the needle.
I will have to look at the standard and see what I can do. Interested to hear if anyone else is doing this or mastered the technique.
Gina
Gina Ward R.N., VA-BC