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/ or 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.  Contact your line insertion team for support if you believe SecurAcath needs to be removed.

SecurAcath removal:

There are two methods of removing SecurAcath; the fold method and the cut method.

We advocate the use of the fold method for all line types and patients including paediatrics.  It is fast,  simple and painless if performed correctly.

Should I take the line out First?

Knowing whether to remove your line first, or the SecurAcath first may be confusing.  Use the below flow chart to determine which method of removal is most appropriate for your situation.

Line and SecurAcath removal:

PICC’s and drains

When the line requires removal, remove the line first and then SecurAcath.  This method should not be used for CICC’s (CVC’s) see below.

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.

SecurAcath removal: Leaving the line in-situ

If the line is still required but SecurAcath needs to be removed, carefully secure the line to eliminate movement or migration. 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.

CICC’s

Always remove SecurAcath first

When removing CICC lines, always remove SecurAcath first, leaving the line in situ.  The line can then be carefully removed as per hospital protocol.

This allows you to focus on applying pressure to the exit site to avoid the risk of air embolus following line removal.

Good practice tips for SecurAcath removals

 

  • Always apply a saline soak for 3-5 minutes prior to removing SecurAcath. This softens the skin and dissolves any crusts that may have formed around the legs.
  • Ensure you tether/support the patients skin as you lift the SecurAcath out.
  • If the patient is able, ask them to take a deep breath in and exhale slowly. Remove the SecurAcath during the exhalation.

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