Nurses who are RNs or Registered nurses can remove an external jugular IV, as long as the nurse is qualified and follows their specific hospitals protocols.
Infusion Nurses Society or INS states explicitly that a trained and proficient RN may remove, care for and insert external jugular peripheral intravenous catheters (EJ PIVs) and also peripherally inserted central catheters or EJ PICCs.
Although because of the necks specific anatomy and the risks that are associated with major blood vessels, several strict criteria also must be met before a nurse is able to perform the procedure of removing the external jugular IV.
The nurse must meet strict requirements before they are qualified to remove external jugular IVs.
These strict requirements include.
Have demonstrated competency.
The nurse who removes the external jugular IV, must have specific training and institutional check offs regarding the specialized care and discontinuation of the lines in the neck.
And the policy of the hospital or facility must also allow the RN to remove the external jugular IV, even if they are qualified to do so.
While state nursing boards do also generally include external jugular IV removal to be within an RN's scope of practice, the individual hospitals and facilities have the final say and authority to dictate which units or certified teams are allowed to pull the external jugular IV lines.
And before removal of the external jugular IV, the nurse also must confirm whether the external jugular IV is a short peripheral catheter or if it's a central line like an EJ PICC, because central lines also require different positioning and air embolism protocols during the removal.
Also LPNs or Licensed Practical Nurses or Licensed Vocational Nurses or LVNs are often not permitted to manage or even remove the lines in the jugular vein.
The removal of external jugular IV and even inserting of the external jugular IV require specialized care.
Because unlike the standard IV that is in the hand or the arm, removing a line from a person's neck carries unique physiological risks.
The main risks when removing and inserting external jugular IVs include bleeding and hematoma and air embolism.
The human neck is a highly vascular area, which cannot be easily compressed with a tight tourniquet.
And so nurses must instead apply direct and steady manual pressure immediately upon the removal of the external jugular IV to prevent internal bleeding or airway compression.
And because the external jugular vein is also close to the central thoracic cavity, negative intrathoracic pressure can also pull air into your bloodstream during removal if the person is sitting upright.
And so patients are often placed flat or supine or in Trendelenburg position during removal or discontinuation of the external jugular IV.