Removing Intravenous (IV) and Intra-Atrial Lines
An intravenous line (or IV) is used to introduce fluid or medication directly into the bloodstream. Although they are inserted with a needle, all that is left in the body is a plastic cannula. They can have one to three lumens (ports).
Peripheral IV Overview:
Peripheral IV Overview:
- A peripheral IV is generally inserted in the hand or forearm. The cannula is up to 1 inch long. It is generally held in place with a piece of tape or, rarely, with a suture.
- A Midline IV is inserted in the elbow and is 3-10 inches long, not going past the armpits.
- The midline IV is held in place by a burr at the end of the cannula as well as with tape.
- A PICC line, like a midline IV, is inserted through a vein in the elbow but goes all the way to the Vena Cava (the vein returning blood to the heart).
- The PICC line is usually held in place with a plastic adhesive stabilizer. It may be stitched into the skin at the place of insertion to hold it in place.
- PICC lines have one or two ports.
- Like a PICC line, a CVAD goes directly to the heart — although it is usually inserted directly under the collar bone or jugular vein in the neck.
- CVADs have one or two lumens (ports).
- Before removing any IV line, first prepare Monsel's solution or another blood coagulating agent, as well as webril/cotton or a fluffed-up Q-Tip to stop bleeding.
- If possible, the limb from which the IV is being removed should be elevated above the rest of the body.
- Carefully remove any bandages and medication discoloration (iodine, betadine, etc.) on or around the IV port.
- In the case of a PICC line, it is generally held in place with an adhesive plastic stabilizer. This can be removed with alcohol.
- If the IV is stitched in place to the skin, cut the stitch.
- Hold a piece of cotton firmly just behind the location where the cannula enters the skin.
- Slowly and smoothly pull the IV out. (In the case of a longer cannula, it is generally held in place by a small burr at the end of the cannula. Removing it may require a little more force.)
- PICC lines will take longer to pull out since they are much longer. Don't be concerned with the length; keep pulling until it is completely out of the body.
- Continue applying pressure until more Monsel's solution is applied. The Monsel's solution should be applied as far into the hole as possible. This is most effective with a fluffed up Q-tip. If the bleeding persists, pack the hole with Monsel's-soaked cotton.