1. Introduction to SecurAcath Removal

SecurAcath stays in place for the life of the line.  Indications for SecurAcath removal are:

  • The line is to due to be removed
  • Improper SecurAcath placement
  • Sensitivity to SecurAcath

Lines can remain in-situ for many months and in some cases years, SecurAcath never needs to be changed.

Improper SecurAcath placement

The line inserters are careful to place the SecurAcath so that the soft flexible feet sit comfortably in the subcutaneous layer of the skin where there are no nerve endings.  When properly placed, the patient will be unaware of the device, in the same way that they can not feel the line in the skin.

If SecurAcath has been improperly placed, the patient will experience pain at the insertion site and potentially referred pain to the nerve ending point as the feet of device irritate the nerve.

Patients may describe the sensation as a sharp or shooting pain which may be aggravated by limb movement.  SecurAcath may be removed without moving or dislodging the line and an alternative method of securement used.

Sensitivity to SecurAcath

The legs and feet of SecurAcath are made from Nitinol, a memory metal that is used to make many medical devices including stents.  It is very strong and flexible and suitable for patients with sensitive skin.  Patients contraindicated for the device are those with a known metal sensitivity.

Those sensitive to the device may develop a localised erythema (redness) and may experience itching, this will be easily distinguished from a potential infection.  SecurAcath may be removed without moving or dislodging the line and an alternative method of securement used.

Line and SecurAcath removal:

PICC’s and drains

Remove the line first

Removing the line first provides more room to manoeuvre the feet out of the exit hole.

Ensure you have achieved haemostasis prior to SecurAcath removal.

CICC’s

Always remove SecurAcath first.  This allows you to focus on applying pressure to the exit point  to avoid the risk of air embolus following line removal.

Hints and tips

 

  • Always apply a saline soak for 3-5 minutes prior to removing SecurAcath to soften the skin and remove any crusts that may have formed around the legs.
  • Ensure you tether/support the patients skin
  • Ask the patient to take a deep breath in and breathe out slowly during the removal if they are able.

SecurAcath removal leaving the line in-situ

The line must be carefully secured to eliminate movement and migration during the SecurAcath removal. Consider using a securement tape or tether it firmly with your free hand.

The fold method must be adopted. Do not attempt the cut method with the line in-situ.

Line removal must only be performed by competent staff in line with local policies and procedures.