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Existing Catheters

Clinical Indications:

    Inability to obtain adequate peripheral access.
    Access of an existing venous catheter for medication or fluid administration.
    Central venous access in a patient in cardiac arrest.

Procedure:

    1. Clean the port of the catheter with alcohol wipe.

    2. Using sterile technique, withdraw 5-10 ml of blood and discard syringe in sharps container.

    3. Using 5cc of normal saline, access the port with sterile technique and gently attempt to flush the saline.

    4. If there is no resistance, no evidence of infiltration (e.g., no subcutaneous collection of fluid), and no pain experienced by the patient, then proceed to step 4. If there is resistance, evidence of infiltration, pain experienced by the patient, or any concern that the catheter may be clotted or dislodged, do not use the catheter.

    5. Begin administration of medications or IV fluids slowly and observe for any signs of infiltration. If difficulties are encountered, stop the infusion and reassess.

    6. Record procedure, any complications, and fluids/medications administered in the Patient Care Report (PCR).

Competency Based Skill Requirements:

    Maintain knowledge of the indications, contraindications, technique, and possible complications of the procedure.

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