Procedure 40 — Venous Access: Existing Catheters

What patient need indicates use of an existing catheter for venous access?

Medications or fluid needed by the patient.

What site condition must be absent to use an existing catheter?

No signs of infection, swelling, or drainage from the insertion site.

When can dialysis catheters be used for venous access?

Only during cardiac arrest or obvious peri-arrest situations.

What is required for other treatment needs besides cardiac arrest or peri-arrest when a dialysis catheter is present?

Peripheral IV access or prior medical control authorization to use the dialysis catheter.

How is the distal port of an existing catheter cleaned before use?

Scrub it with an alcohol wipe.

What technique is used to withdraw blood before using an existing catheter?

Sterile technique.

What volume of blood is withdrawn and discarded before using an existing catheter?

10 mL.

Where is the syringe discarded after withdrawing blood from an existing catheter?

The sharps container.

Why is blood withdrawn and discarded before using an existing catheter?

To prevent the patient from receiving a heparin bolus if the central line is not a closed-end or valve-tip catheter.

What volume of saline is used to flush an existing catheter before use?

10 mL of normal saline.

What technique is used to access the port and flush an existing catheter?

Sterile technique, flushing gently.

What three findings allow proceeding to use an existing catheter?

No resistance, no evidence of infiltration, and no pain experienced by the patient.

Name three findings that indicate an existing catheter should not be used.

Resistance to flush, evidence of infiltration, or pain experienced by the patient.

What additional concern indicates an existing catheter should not be used?

Any concern that the catheter may be clotted or dislodged.

How should medication or fluid administration begin through an existing catheter?

Slowly, while observing for any signs of infiltration.

What should be done if difficulties are encountered while using an existing catheter?

Stop the infusion and reassess.

What must be recorded in the PCR after using an existing catheter?

The procedure, any complications, and fluids/medications administered.

What provider level performs venous access via existing catheters?

EMT-P.