• Proper technique is essential to prevent air embolism.
• Always use semi-sterile technique with sterile gloves and a suture removal kit.
• Make sure the line is not tunneled and does not have to be taken out by interventional radiology.

Procedure:

• Position the patient in Trendelenburg (reverse Trendelenburg for femoral lines); remove any pillows.
• Remove all bandages and gauze. Ensure that no IVF or medications are running through the line.
• Cut and remove all suture material being careful to not leave any behind (this can cause scarring and/or infection).
• Instruct the patient to continuously hum or Valsalva; simultaneously and swiftly remove the line.
• REMEMBER: deep inspiration on removal will increase negative pressure in the thorax (increasing risk of air embolism). If patient is intubated on a pressure control or volume control mode of ventilation, remove catheter during beginning of expiratory phase (this is when they will have the highest intrathoracic pressure).
• Dress the site with sterile gauze coated with petroleum jelly and place a Tegaderm over the gauze. Gauze can be removed after 24 hours unless the patient has a coagulopathy.