Q: In our critical care cardiovascular committee, the physicians asked if trained critical care nurses can remove a pulmonary artery catheter if the patient has an implantable cardioverter defibrillator in place. The AACN Procedure Manual for Critical Care states that critical care nurses should not remove pulmonary artery catheters if wires are present in the right side of the heart; the manual does not differentiate between temporary and permanent wires. If it is accepted practice for nurses to remove pulmonary artery catheters in patients with implantable cardioverter defibrillator wires, is there any time frame that would preclude such removal by nurses?
A: Kathleen Epping, RN, MSN, ACNP-BC, and Beth Hammer, RN, MSN, ANP-BC, reply:
Currently, evidence is insufficient to support any conclusive statement about a specific time frame during which a pulmonary artery catheter should not be removed by a nurse in a patient with a permanent pacer or implantable...