Central Line Removal 〰️
Guide for central line removal. Technique, precautions, complications, and post-removal care for CVC and PICC lines.
🧠 Indications for Removal
- Line no longer required for treatment
- Suspected or confirmed line-associated infection
- Malfunction or occlusion of line
- Completion of therapy (e.g. antibiotics, TPN)
⚠️ Contraindications / Precautions
- Uncorrected coagulopathy – discuss with senior
- Unstable patient requiring central access
- Suspected thrombus – consider ultrasound
📞 What to Check Before Removal
- Is the line still needed?
- Check coagulation status and platelets
- Any signs of infection at site or systemic?
- Is patient anticoagulated?
- Check if tip needs to be sent to microbiology
🧰 Equipment
- Sterile gloves and dressing pack
- Suture removal kit (if applicable)
- Gauze and occlusive dressing (e.g. Tegaderm)
- Sterile scissors if line is sutured
📝 Procedure
- Explain procedure and gain verbal consent
- Wash hands, apply gloves, and position patient supine - ideally with insertion site below heart level or Trendelenburg position
- Remove dressings and cut sutures if present
- Ask patient to perform Valsalva (or exhale and hold breath) as you gently withdraw the line whilst applying pressure to the site with dry gauze
- Immediately apply firm pressure for at least 5–10 minutes
- Cover with occlusive dressing and document procedure
- Inspect the catheter tip (ensure it’s intact) ± send for culture if indicated
- Ask patient to remain lying flat for 30 minutes post-removal
🧾 Documentation
- Time, date, and indication for removal
- Who removed it and how patient tolerated it
- Site condition and haemostasis achieved
- Whether tip was sent for culture
⚠️ Complications to Watch For
- Bleeding or haematoma
- Air embolism – ensure Valsalva or breath hold was done
- Line fracture or retained fragment – inspect tip!
- Infection at removal site