Central Line Cesar — Central Lines & Air Embolism: Clamp It, Position It, Protect It
His tubing came apart for only a few seconds — and suddenly he is gasping, dizzy and dropping his pressure
Cesar's IV tubing disconnects during a dressing change. Within seconds he is short of breath, pale and frightened.
Cesar has a central venous catheter. Two dangers define central line care: infection and air embolism. Air can be sucked into the catheter whenever the system is open, especially during a deep breath. If an air embolism is suspected — sudden dyspnea, chest pain, anxiety, hypotension — CLAMP the line immediately, place the client on the LEFT side in Trendelenburg to trap air in the right atrium, give oxygen, and call for help. Infection prevention means sterile dressing changes, scrubbing the hub, and removing the line as soon as it is no longer needed. Blood return should be verified before infusing.
Read Central Line Cesar's full story →The story arc
The setup
Cesar needs long-term antibiotics, so a central line is placed in his chest.
The turn
During a dressing change his tubing separates while he takes a deep breath in.
The crisis
Cesar gasps, grabs his chest and says the room is spinning. His pressure drops and his heart races.
The save
The nurse clamps the catheter, turns him onto his LEFT side with the head down, applies oxygen and calls for help.
NCLEX study section — Central Lines & Air Embolism: Clamp It, Position It, Protect It
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Safety & Infection Control
Take this chapter into practice questions on the same topic.