[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [IV therapy and fluids](https://durgical.com/en/nursing/areas/iv-fluids/) › Central venous catheter care # Central venous catheter care - Procedure A central line is handled with strict aseptic technique: an intact dressing, a disinfected connector, flushing without force and removal once it is not needed. Updated Nov 5, 2026 ## Key points - Review every day whether the catheter is still needed; remove it as soon as it is not (CDC 2011). - Antisepsis with chlorhexidine in alcohol (above 0.5 %), scrubbing for 30 seconds, then let it dry. - Transparent dressing: at least every 7 days; gauze: every 2 days; sooner if damp, loose or soiled. - Scrub the connector for at least 15 seconds before every access and let it dry. - Never flush against resistance; use the syringe size the protocol sets, because small syringes create more pressure. - Air embolism: clamp, left side-lying with the head down, oxygen and the rapid response team. ## What it is A central venous catheter ends in a large vein near the heart. It allows long therapies, high-osmolarity solutions, vesicants, resuscitation and haemodynamic monitoring. The main types are the peripherally inserted central catheter (PICC), the non-tunnelled, the tunnelled and the implanted port. Its main risk is central line-associated bloodstream infection; the prevention bundle and a daily review of whether it is still needed are the core of its care (CDC 2011 guideline). ## Indications - Long-term IV therapy. - High-osmolarity solutions or vesicant drugs. - Emergency access for fluid resuscitation. - Haemodynamic monitoring. - Scheduled care: dressing and connector changes, flushing, blood sampling and site assessment. ## Contraindications and precautions - Aseptic non-touch technique; a mask for you and the patient during the dressing change. - Chlorhexidine allergy: use the alternative the protocol names (povidone-iodine, 70 % alcohol). - Under two months of age, the antiseptic is set by the paediatric protocol. - Do not submerge the catheter in water; cover it with an impermeable cover to shower. - Do not draw blood from a lumen running parenteral nutrition. ## Equipment - Sterile dressing kit with sterile gloves and masks. - Chlorhexidine in alcohol and a sterile transparent semipermeable dressing. - A new needleless connector and antiseptic caps or pads for the connector. - Prefilled saline syringes of the size the protocol sets. - A label for date, time, initials and the next change date. ## Step by step (and why) - Check the site, dressing and external catheter length every shift — detects infection and migration. - Hand hygiene; a mask for you and the patient, who turns their head away — avoids contaminating the site. - Remove the dressing without pulling the catheter and look for redness, discharge or swelling — a finding changes the plan. - Clean with chlorhexidine in alcohol, scrubbing for 30 seconds, and let it dry — dry antiseptic works better. - Apply the sterile transparent dressing and label it — you can see the site and know when to change it. - Scrub the connector for at least 15 seconds and let it dry before every access; enter only with sterile devices. - Aspirate for blood return and flush with saline using a pulsatile push-pause technique — helps clear the lumen. - Never force against resistance; look for kinks and follow the protocol — force can rupture the catheter. - Clamp according to the connector type and change sets and connectors as often as the protocol says. - Ask every day whether it is still needed and document — timely removal is the best prevention. ## Complications - Central line-associated bloodstream infection: fever, chills, redness or discharge at the site. - Occlusion: resistance on flushing and poor blood return. - Air embolism: sudden breathlessness, persistent cough, chest pain, altered mental status or a neurological deficit. - Pneumothorax after insertion: pleuritic pain, breathlessness, tachypnoea, cyanosis, dry cough. - Catheter migration (the external length changes) and thrombosis (with a PICC, a larger arm circumference). - Catheter breakage. ## Next step: when to call for help - Air embolism: clamp the catheter, place the patient left side-lying with the head down, give oxygen and call the rapid response team. - Call for fever, chills, redness or discharge: expect blood cultures. - Call if there is resistance or no blood return; do not force it. - Call if the external length changes or the arm circumference grows with a PICC. - Breakage: clamp between the exit site and the break, cover with sterile gauze and call. Complete dislodgement: rapid response. ## Test yourself Think of the answer, then tap the question to see it. ## Which measure prevents central line-associated bloodstream infection the most? Removing the catheter as soon as it is not needed, with a daily review of its need, together with aseptic technique, an intact dressing and connector disinfection. ## How often is the transparent dressing of a short-term central catheter changed? At least every 7 days (gauze every 2 days), and sooner if it is damp, loose or soiled. ## Which position is used if an air embolism is suspected? Left side-lying with the head down, after clamping the catheter; oxygen is given and the rapid response team is called. ## Why is a central catheter not flushed with small syringes? Because they create more pressure inside the lumen and can rupture the catheter. Use the syringe size the protocol sets. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/nursing/central-venous-catheter-care/) ## Connections ## Related 2 - [Preventing healthcare-associated infections: the care bundles](https://durgical.com/en/nursing/preventing-healthcare-associated-infections-the-care-bundles/) - [IV complications: phlebitis, infiltration and extravasation](https://durgical.com/en/nursing/iv-complications-phlebitis-infiltration-and-extravasation/) [← All of nursing](https://durgical.com/en/nursing/) Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order. Sources: [Nursing Advanced Skills, 4.2 Manage Central Lines: Basic Concepts](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Advanced_Skills_(OpenRN)/04%3A_Manage_Central_Lines/4.02%3A_Basic_Concepts) (Open RN (Chippewa Valley Technical College), LibreTexts, 2023); [Nursing Advanced Skills, 4.3 Manage Central Lines: Applying the Nursing Process](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Advanced_Skills_(OpenRN)/04%3A_Manage_Central_Lines/4.03%3A_Applying_the_Nursing_Process) (Open RN (Chippewa Valley Technical College), LibreTexts, 2023); [Guidelines for the Prevention of Intravascular Catheter-Related Infections (2011): Summary of Recommendations](https://www.cdc.gov/infection-control/hcp/intravascular-catheter-related-infections/summary-recommendations.html) (Centers for Disease Control and Prevention, 2011). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/nursing/central-venous-catheter-care/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/central-venous-catheter-care/