1. Review patient’s coagulation status and ensure within normal range
  2. Ensure all lines are clamped/locked
  3. Position patient supine. Turn the patient’s face away from the site as appropriate
  4. Remove dressing. Do not exert tension on the catheter
  5. Assess the site for drainage, swelling, and inflammation
  6. Prepare the dressing tray and don gloves
  7. Cleanse area with Chlorhexidine 2% aqueous. Allow at least 30 seconds of contact time (to dry)
  8. Being careful not to cut the line, use sterile scissors to remove any sutures
  9. Apply sterile gauze with gentle pressure over the insertion site.
  10. Grasp the catheter by the hub and slowly withdraw the catheter while having the patient perform a Valsalva manoeuvre or exhale slowly
  11. If resistance is noted while withdrawing the line stop, reassess, reposition and seek assistance as required
  12. Exert direct pressure on the site with gauze until bleeding has stopped completely. For central lines, this will usually be a minimum of 5 minutes.
  13. Once the bleeding has ceased, cover the exit site with sterile gauze and an occlusive dressing
  14. Inspect the line for abnormalities, evidence of infection, and length. Note: If the catheter is ragged or damaged, notify IVR immediately. Retain the catheter and measure its length.
  15. Discard in biohazardous waste if not being sent for culture. If ordered, send the tip of the catheter to the Microbiology Laboratory for culture and sensitivity:

o Use sterile scissors to cut off at least 3cm of the tip
o Place the tip in a sterile container and seal
o Send the specimen immediately to the Microbiology Laboratory
o 2 sets of blood cultures are required (as ordered) when tips are sent for culture and sensitivity:

  • Peripheral site: 1 aerobic + 1 anaerobic tube
  • Line: 1 aerobic tube for each lumen