Vascular Access Device Removal Flashcards

A patient receiving mechanical ventilation needs a nontunneled jugular CVC removed. When should the catheter be withdrawn to minimize air embolism risk?

Answer: During the inspiratory phase of the ventilator cycle

Positive-pressure inspiration raises intrathoracic pressure above atmospheric, reducing the gradient that draws air into the vein.

Which dressing is most appropriate immediately after removing a nontunneled CVC?

Answer: An air-occlusive dressing such as petroleum-based gauze covered by a transparent dressing

An air-impermeable dressing seals the skin-to-vein tract and prevents delayed air entry.

After CVC removal, how long should the air-occlusive dressing generally remain in place?

Answer: At least 24 hours and until the site is epithelialized

The dressing is kept at least 24 hours and changed/reassessed until the tract has healed.

A patient who cannot perform a Valsalva maneuver due to cognitive impairment needs a subclavian CVC removed. What is the best alternative?

Answer: Have the patient hold the breath at end-exhalation, or remove the catheter during exhalation

Removing during exhalation keeps intrathoracic pressure higher than during inspiration, reducing air entry.

Immediately after removing a femoral arterial catheter, how long should direct manual pressure typically be held at minimum?

Answer: 10 minutes

Femoral arterial sites generally need at least 10 minutes of pressure, longer if the patient is anticoagulated.

Which assessment finding after PICC removal confirms the catheter was removed intact?

Answer: The removed length matches the documented inserted length and the tip is smooth and complete

Comparing length to insertion records and inspecting the tip confirms no fragment remains.

Which patient position is preferred for removing an internal jugular CVC when tolerated?

Answer: Supine or Trendelenburg so the insertion site is below the level of the heart

Placing the site below the heart increases venous pressure at the site and reduces air entry.