Central lines (central venous catheters) are removed when the risks outweigh the benefits or when they’re no longer needed. This decision should always be guided by the clinical team in charge of the patients care. 
 
Common reasons include: 

1. No Longer Clinically Necessary 
Completion of IV therapy (e.g., antibiotics, chemotherapy) 
Patient can tolerate oral or peripheral IV medications/fluids 
Hemodynamic monitoring no longer required 

2. Infection or Suspected Infection 
Catheter-related bloodstream infection (CRBSI) 
Local signs of infection: redness, warmth, swelling, pain, or pus at the site 
Unexplained fever or sepsis with the line as a suspected source 

3. Catheter Malfunction 
Occlusion or inability to flush/aspirate 
Catheter damage, breakage, or leakage 
Malposition or migration of the catheter tip 

4. Thrombosis or Embolic Complications 
Catheter-associated thrombosis 
Suspected or confirmed embolism related to the line 

5. Mechanical or Insertion-Related Complications 
Bleeding or hematoma at the site 
Vessel perforation 
Pneumothorax or haemothorax (depending on site) 

6. Local Site Problems 
Persistent pain at insertion site 
Skin breakdown, erosion, or poor healing 
Phlebitis (more common with PICCs) 

7. Patient-Related Factors 
Patient discomfort or intolerance 
Patient pulling at or dislodging the line 
Change in goals of care (e.g., transition to comfort care) 

8. Line No Longer Safe to Maintain 
Dressing cannot be kept clean, dry, and intact 
Poor line care increasing infection risk 
 
Central line removal 

If the central line is not functioning before removal as a senior nurse for help.  

If it is directed to remove the catheter, and competent to do so, the following process is an example of steps which are followed: 

Equipment: 
1. Personal protective equipment 
2. Sterile dressing pack 
3. Tape 
4. Extra gauze 
5. Chlorhexidine and Alcohol swab 
6. Dressing trolley 
7. Suture cutter 
8.  Transparent dressing with pad 
9. Sterile scissors  
10.  Specimen pot 

Pre‐procedure 
1. Introduce yourself to the patient, explain and discuss the procedure, and gain consent. 
2. Check the patient’s platelet and coagulation screen. 
3. Prepare equipment 
4. Wash hands with soap and water, or an alcohol‐based handrub. 

Procedure 
1. Turn the three‐way tap diagonally closest to the patient. 
2. Close the roller clamp on the flush set. 
3. Deflate the pressure cuff. 
4.  Place the patient in reverse Trendelenburg (30 degrees head down)  
4. Clean hands with an alcohol‐based handrub and apply gloves. 
5. Loosen and remove dressing and any tape from the cannula site. Clean the cannula site area with a 2% chlorhexidine in 70% alcohol swab. 
6.  Cut the suture holding the line in place 
7. Place sterile gauze over the area and gently remove the cannula. 
8. Apply direct pressure for a minimum of 5 minutes. 
9. Apply a clean, sterile, dressing. 
(note: it is common to send the tip of the line for microscopy, culture and sensitivity (MC+S) if directed cut the tip of the line (about an inch of length will suffice) into a specimen post and send to the microbiology lab for processing) 

Post‐procedure 
1. Sit the patient up (30 degrees) 
2. Remove gloves and dispose of equipment appropriately. 
3. Document the date and time of removal in the patient’s notes.