Central Venous Catheter DEATH

Only about a year ago in our Hospital a patient died after a CVC was removed incorrectly. The catheter was inserted in the internal jugular vein and removed slowly while the patient was still sitting up (orthostatic position). The combination of slow removal and inappropriate positioning (central venous pressure in this position is in the negatives) caused a fatal air embolism to be sucked into the circulation.

So when removing a CVC from the internal jugular vein, make sure the patient is supine and the catheter is removed with relative speed and the wound is covered well to prevent a delayed air embolism. 
Nice guide HERE

A central venous catheter (CVC) is a catheter in which the tip lies inferior or superior vena cava close to the entrance or within the entrance to the right atrium. They are useful because they can be left in alot longer than peripheral venous catheters and can be used to give larger volumes of fluids and drugs, alot faster too. They often have mutiple lumen to attach multiple lines and give drugs at the same time.

BMJ Review on CVCs

Types of CVC:

• Tunneled CVC: catheter is tunneled under the skin after insertion (less visible and moves around less, also helps prevent infection)
• Non-tunneled CVC: fixed in pace at the site of insertion typically with a suture, like our example above in the internal jugular vein. 
• Peripherally inserted central catheter (PICC): Inserted in the arm rather than neck or chest
• Implanted port: similar to the tunneled CVC but the end if left under the skin as well, drugs are injected in the port through the skin.