Non‑Tunneled Central Line Removal — “Power Minute”

High‑risk moment: the tract is briefly open to air and bleeding. Our job is to seal the tract and control bleeding.

Scope: Non‑tunneled CVC only (IJ / subclavian / femoral). Not PICC. Not tunneled.
MEMORY AID
Position.
Exhale.
Seal.
Prevent air embolism + bleeding at removal.

60‑Second Standard Work

1
Set up (order + supplies)
  • Confirm provider order + line type/site (non‑tunneled only)
  • Quick risk check per unit expectations (bleeding/anticoag)
  • Supplies ready: sterile gloves, CHG, sterile gauze, tape, occlusive dressing
2
Air embolism prevention (position + breath)
  • IJ/Subclavian: Trendelenburg if tolerated
  • Femoral (or can’t tolerate Trendelenburg): supine
  • Best: Valsalva during pull; otherwise pull on exhalation
  • Ventilated/unable to follow commands: coordinate exhalation phase/pause per RT/provider
3
Remove smoothly + seal immediately
  • CHG prep; let dry
  • Sterile gauze over site before pull (maintain coverage as the catheter exits)
  • Smooth, steady removal on Valsalva/exhale
  • Hold firm pressure 2–5 min until hemostasis
  • Apply dry gauze + occlusive (Tegaderm) to seal tract
4
Aftercare
  • Occlusive dressing: ≥ 24 hours
  • Site checks: 5 / 15 / 30 / 60 min for bleeding/hematoma
  • Escalate immediately if air embolism symptoms occur

Red Flags (Escalate)

Possible air embolism

Sudden SOB, chest pain, cough, acute neuro change, hypotension/syncope.

Bleeding / hematoma

Persistent bleeding, expanding hematoma, dizziness, hypotension, patient distress.

Documentation (quick)

Chart

Tip intact • pressure held 2–5 min • hemostasis achieved • occlusive dressing applied • tolerated well • site checks 5/15/30/60.

Note

Length documentation is not required (lines are never trimmed).