Central lines are tubes inserted into veins or arteries to deliver medication or fluids directly to the heart. They are usually placed during surgery or other medical procedures.
If they become blocked, however, they can cause serious complications.
Learning how to safely remove them is an important skill for medical professionals, and we have put together all you need to know to achieve this.
What Is A Central Line?
A central venous catheter (CVC) (see also ‘How To Insert A Coude Catheter‘) is a thin tube that is inserted through a vein in order to provide access to the circulatory system. Central lines are commonly used in hospitals to administer medications, blood transfusions, and intravenous nutrition.
Removing a CVC requires special training and equipment. The procedure involves inserting a needle into the catheter and then using a syringe to withdraw fluid from the catheter.
This method has risks associated with it, such as infection and bleeding. In addition, if the patient does not receive proper care after the removal of the line, there may be long-term health consequences.
The most common type of central line is called a “peripheral” line because it is inserted into a large vein near the surface of the skin. These lines are typically used to give patients IVs and medications.
Peripheral lines are often left in place for several days at a time.
Central lines are also known as “central venous catheters,” “intravenous catheters,” and “pigtail” lines.
How Do I Know When It’s Time To Replace My Central Line?
The timeline for replacing a central line will depend largely on the type of treatment that is being administered – whether it is chemotherapy, antibiotic or pain medicine.
According to experts, central lines that are designed for continuous infusions should be changed at no more frequently than 4 days, but at a minimum of 7 days, while the administration of fat emulsions or blood products means that the line and tubing should be changed every 24 hours at a minimum.
There are a few indications that it is time to change and replace a central line, and these include:
- Redness around the insertion site
- Swelling around the insertion site
If any of these symptoms occur, contact your doctor immediately – they could be a sign that an infection is developing, and urgent treatment may be required.
How Do I Remove A Central Line?
Remove a central line by inserting a needle into the lumen of the catheter (see also ‘How To Change A PICC Line Dressing‘) and withdrawing the fluid. You must use extreme caution when removing a central line since the catheter can easily break off inside the body.
You Will Need:
- A sterile technique
- An 18 gauge needle
- Sterile gloves
- A syringe
- A small amount of saline solution
1. Insert The Needle Into The Catheter
Insert the needle into the lumen where the catheter enters the vein. Make sure to insert the needle straight down into the catheter.
Don’t force the needle into the catheter; instead, gently push the needle into the catheter’s wall.
2. Withdraw Fluid From The Catheter
Once the needle is properly positioned, slowly pull back on the plunger of the syringe until you feel resistance. Then, slowly remove the syringe and allow the fluid to flow out of the catheter.
3. Clean Up
After the fluid has been removed, clean up the area around the insertion site with alcohol wipes. If you have trouble cleaning up the area, ask someone else to help you.
4. Check For Infection
After the area has been cleaned, check the insertion site for redness, swelling, or other signs of infection. If you find anything unusual, call your doctor right away.
Common Mistakes When Removing A Central Line
With practice, care, and patience, removing a central line should become a relatively simple process.
There are, however, some common mistakes that many medics make – being aware of these will help you to avoid the same errors and provide excellent standards of care.
- Not Using Sterile Technique
When removing a central line, always use a sterile technique. This includes wearing sterile gloves and using a new needle each time. Failing to use a sterile technique can result in serious infections.
- Failing to Wash Hands Before Starting Procedure
Before starting the procedure, wash your hands thoroughly with soap and water. Also, make sure to wear a mask if there is any chance that you might come into contact with blood or bodily fluids.
- Not Wearing Gloves
Wear sterile gloves whenever possible. They protect against cuts and scratches which could otherwise contaminate the skin.
- Using Too Much Force When Pulling Back On The Syringe
Pulling back on the syringe too hard can cause the catheter to tear loose from the vein. Instead, apply gentle pressure as you withdraw the syringe.
- Not Checking For Blood In The Drain Tube After Removal
Make sure to check the drain tube after removal. If blood is present, flush the tube with more saline solution before reinserting the catheter.
- Reusing Needles
Reusing needles can lead to serious infections. Always discard used needles safely and dispose of them in sharps containers.
In addition, you should never handle needles or other medical equipment without first sterilizing it. You must also be careful not to touch the tip of the needle while handling it.
- Failure to Follow Proper Disposal Procedures
Always follow proper disposal procedures when disposing of needles, tubing, and other medical equipment. Never throw items such as needles, syringes, IV bags, etc., into trash cans or sewers.
- Not Following All Safety Precautions
All medical personnel needs to take all necessary precautions to ensure their own safety. These include wearing protective clothing (gloves, gowns, masks, eye protection), using appropriate disinfectants and hand sanitizer where required, and avoiding unnecessary exposure to blood-borne pathogens.
- Failure to Report Any Serious Incidents
If you witness an incident involving patient harm, report it immediately by telling your supervisor or line manager – if you believe that a mistake was made during your shift, you should notify your supervisor immediately.
It is important to report medical errors so they may be addressed and prevented in the future.
Final Thoughts
Removing a central line is a very important part of providing quality healthcare services, and following these guidelines will help you to perform this task correctly and prevent any potential problems, keeping your patients safe and healthy.