Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [356], C).
2. 2.Show
   Check the patient's platelet and coagulation screen.
   To prevent delay in removal while coagulation is corrected. E
3. 3.Show
   Prepare a trolley.
   To reduce the risk of cross‐infection (DH [117], C; Fraise and Bradley [156], E).
4. 4.Show
   Wash hands with soap and water, or an alcohol‐based handrub, and dry before leaving the clinical room.
   To reduce the risk of cross‐infection (DH [117], C; Fraise and Bradley [156], E).

Procedure

1. 5.Show
   Turn the three‐way tap diagonally or turn off the flow switch, depending on the arterial product.
   To prevent backflow of blood into the cannula. E
2. 6.Show
   Turn off the flush set.
   To prevent spillage when removing the cannula. E
3. 7.Show
   Deflate the pressure cuff.
   Pressure is no longer required. E
4. 8.Show
   Loosen the transparent dressing and tape from the cannula site.
   To facilitate removal of the cannula. E
5. 9.Show
   Clean hands with an alcohol‐based handrub.
   To minimize the risk of infection (DH [117], C; Fraise and Bradley [156], E).
6. 10.Show
   Apply gloves.
   To prevent contamination of hands with blood (Loveday et al. [278], C).
7. 11.Show
   Remove dressing and tape. Clean the cannula site area with a 2% chlorhexidine in 70% alcohol swab.
   To reduce the risk of infection (DH [117], C; Fraise and Bradley [156], E).
8. 12.Show
   Place sterile gauze over the area and gently remove the cannula.
   To minimize bleeding and blood spillage (Loveday et al. [278], C).
9. 13.Show
   Apply pressure for a minimum of 5 minutes.
   To prevent haematoma and blood loss (RCN [381], C).
10. 14.Show
    Apply a clean, sterile, low‐linting gauze dressing.
    To maintain asepsis and minimize blood loss. E
11. 15.Show
    Secure with tape. Do not create a tourniquet‐type dressing.
    To ensure pressure and to prevent haematoma and blood loss. E

Post‐procedure

1. 16.Show
   Remove gloves and dispose of equipment appropriately.
   To prevent sharps injury (NHS Employers [347], C).
2. 17.Show
   Document the date and time of removal in the patient's notes.
   To ensure adequate records are maintained and enable continued care of the patient (NMC [356], C).