Verify review of labs (INR, plts, etc.)
Verify timing of CVC<unk>  with transfusion services if the patient has received plasmapheresis in the last 24 hours
Patient in Trendelenburg position (IJ/Subclavian) or supine (femoral or cannot tolerate Trendelenburg)
Explain valsalva, have patient perform
For mechanically ventilated pull catheter at the end-inspiration.
Mask, hand hygiene, gloves
Remove old dressing and cut sutures, discard old gloves and change to sterile
Remove CVC
Instruct the patient to valsalva
Gently withdraw catheter while applying firm direct pressure using sterile gauze with antibiotic ointment (occlusive dressing) to insertion site.
Tell the patient to breathe normally after the CVC is removed.
If you encounter resistance, stop the<unk>  and escalate following the chain of command
Continuously apply firm pressure for several minutes until bleeding stops
Observe site for bleeding and hematoma formation
Patient remains supine for 30 minutes post CVC<unk>  or as appropriate to the clinical situation
For mechanically ventilated pull catheter at the end-inspiration.
Instruct the patient to valsalva
Gently withdraw catheter while applying firm direct pressure using sterile gauze with antibiotic ointment (occlusive dressing) to insertion site.
Tell the patient to breathe normally after the CVC is removed.
If you encounter resistance, stop the<unk>  and escalate following the chain of command
Central Line: removal
GU antibiotics
Sepsis antibiotics
Central line: subclavian
Burn dressings
OB/GYN antibiotics
Arterial line
Wound care dressing basics