Procedure 40 - Venous Access: Existing Catheters

What condition allows use of an existing catheter for medications or fluids?

Medications or fluid needed by the patient and no signs of infection/swelling/drainage from the insertion site.

When can dialysis catheters be used per this protocol?

Only during cardiac arrest or obvious peri-arrest situations.

What is required to use a dialysis catheter for other treatment needs?

Peripheral IV access or prior medical control authorization.

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

Scrub with an alcohol wipe.

How much blood is withdrawn and discarded from an existing catheter, and why?

10 mL, discarded in the sharps container, to prevent the patient from receiving a heparin bolus if the central line is not a closed-end or valve-tip catheter.

How much normal saline is used to flush an existing catheter before use?

10 mL.

What findings allow proceeding to medication/fluid administration through an existing catheter?

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

What findings indicate an existing catheter should not be used?

Resistance, evidence of infiltration, pain experienced by the patient, or concern that the catheter may be clotted or dislodged.

How should medications or IV fluids be started through an existing catheter?

Slowly, observing for any signs of infiltration.

What should be done if difficulties are encountered during administration through an existing catheter?

Stop the infusion and reassess.

What should be documented after using an existing catheter?

The procedure, any complications, and fluids/medications administered in the PCR.

What provider level can access existing catheters per CFD protocol?

EMT-P.