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Clinical reference
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ProcedureAwaiting clinical review

Central line care and complications

Access, occlusion and suspected line-infection decision points.

Blood cultures
One set per lumen + peripheral
Dressing change
Per local policy; sooner if soiled or loose

Suspected line infection

  • Signs: fever with access, exit-site erythema or discharge, rigors on flushing, tunnel tenderness.
  • Paired cultures (line + peripheral) allow differential time to positivity.
  • Add Gram-positive cover empirically when line infection is likely.
  • Tunnel infection, port-pocket abscess or persistent positive cultures at 72 h usually means line removal — involve surgery early.

Escalate

  • Rigors during flush plus hypotension — stop the flush, treat as sepsis, escalate.

Occlusion

  • Check for mechanical causes first: clamps, kinks, tight sutures, patient position.
  • Withdrawal occlusion with intact infusion suggests fibrin sheath.
  • Thrombolytic dwell per local policy for thrombotic occlusion; imaging if unresolved.

Sources and local override

  • Local vascular access policy — Flush volumes and lock solutions are centre-specific.

Next review due 2027-02-01.