Option 1: IV Team Consult

Firstly, you can always place a consult to the IV Team to do this for you, the order is "IV Team Consult" and you just choose what you want them to take out. Generally you should try this at the beginning of the day if there is time for the IV team to do it. 

Option 2: Do it yourself

Materials:

Xeroform dressing, 4 x 4s, suture removal kit, chloroprep, sterile gloves. Have a nylon suture and hemostat but don't open, use stitch PRN if the incision was too big and keeps oozing.  

1. Position patient in Trendelenburg (head DOWN). DO NOT DO THIS WITH THE PATIENT SITTING UP, THEY CAN ACTUALLY DIE FROM AN AIR EMBOLISM THIS IS NOT A MYTH. 

2. Remove dressing unsterilley. 

3. Chloroprep the area w/ small chloroprep stick and put on sterile gloves. 

4. Cut sutures

5. Once you start literally pulling it out, tell the patient to hum and hold their hum it while you are taking it out . 

6. Occlusive xeroform dressing --> gauze --> Tape down (tegarderm) 

7. Patient can stop humming once out and occlusive dressing is over. 

8. Ideally hold pressure for 5 minutes (not extremely necessary if too busy). 

9. Tell patient to lay flat for 20 minutes. 

There should be NO resistance. If there is, STOP, place occlusive dressing, and call for help. 

How patient will present if they get an air embolism: instant death vs. stroke. If stroke symptoms, call condition C and tell them you are worried about air embolism, how do we get hyperbaric ASAP (hint: next to escalators in lobby).