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IV Catheter Removal
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Date & Time of IV removal
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Type of device
• • •
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IV Site Location
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Catheter Tip assessment
• • •
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Length of IV Catheter tip removed (Picc) CM
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Dressing Applied
• • •
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Site Assessment (Surround Skin)
• • •
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IV Site Care
• • •
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Reason for IV Removal
• • •
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Interventions during removal
• • •
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Complications during IV removal
• • •
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IV Insertion Comments
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Patient Response
• • •
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