Cheryl Palmer, RN, BSN, CCRN, CRRN
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Removing Central Venous Catheters (CVC)

· By Cheryl Palmer, RN, BSN, CCRN, CRRN

Cover image for Removing Central Venous Catheters (CVC)

One of the procedures that you will be performing quite regularly in the CVICU is removal of a central venous catheter. This is what you need to know about the procedure

Equipment

  • Suture Removal Kit

  • Sterile 4 X 4’s

  • Face mask/splash guard, sterile/non-sterile gloves

  • Tape or Transparent Dressings

  • In order to culture tip:

    • CHG or alcohol swabs

    • Sterile gloves

    • Sterile container


Procedure

  • Verify review of labs (INR, plts, etc.) If platelets are low and or INR is elevated, discuss with the provider before removing CVC

  • Mask, hand hygiene, gloves

  • Remove old dressing and cut sutures, discard old gloves and change to sterile gloves

  • Remove CVC

Positioning during central line removal is a critical intervention to prevent air embolism

  • Inform the patient

  • Place the patient supine (they should not be sitting or upright) should be placed in the head down (Trendelenburg) position for removal

  • Or supine (femoral or cannot tolerate Trendelenburg)

  • Instruct the patient to hold their breath and perform the Valsalva maneuver (forced expiration with the mouth closed) when the catheter is being removed

  • If the patient is unable to cooperate with instructions, the catheter should be removed following inspiration

  • Gently withdraw catheter while applying firm direct pressure using sterile gauze (occlusive dressing) to insertion site. Cover the insertion site immediately with a sterile gauze

  • Tell the patient to breathe normally after the CVC is removed.

  • Maintain firm manual pressure until haemostasis is achieved. The insertion site must then be covered with an air-occlusive dressing, (like Vaseline gauze) which should remain in place for 24-72 hours

  • Observe site for bleeding and hematoma formation

  • Patient remains supine for 30 minutes post CVC removal or as appropriate to the clinical situation

Symptoms associated with venous air embolism include:

Shortness of breath

Hypotension

Loss of consciousness

Cardiac arrest

Treatment of Venous Air Embolism

Placement of the patient in the head-down, left-side-down position,

Administration of 100% O2, and

Cardiopulmonary resuscitation

This content is for education only. It does not replace your facility's policies, your provider's orders, or current clinical guidelines.

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