Central venous access device: Clinical practice guide

This clinical practice guide can support NSW local health districts (LHDs) and hospitals to develop local procedures for the care of patients with a central venous access device (CVAD).

A CVAD is used to deliver fluids, medication and nutrition to patients.

While insertion of a CVAD is a common procedure, it can also have significant risks. There are risks with insertion and removal of a CVAD, as well as risks associated with having a CVAD in place for a period of time. These risks include:

  • infection
  • malposition
  • thrombosis
  • vascular injury
  • air embolus.

The guide provides recommendations for evidence-based clinical practice that can improve patient outcomes.

At a glance

The clinical practice guide covers recommendations for:

  • pre-insertion
  • insertion
  • post-insertion
  • removal.


This is an update to the Clinical practice guideline: Central venous access device post insertion management, published in 2014.

The updated guide has been reviewed by a working group, including expert medical, nursing and allied health representatives from LHDs across NSW.

Published October 2021. Next review 2026.


Vascular air embolism

CVAD management

Removal of CVAD

Scrub the hub

Vascular air embolism


The information on this page is general in nature and cannot reflect individual patient variation. It reflects Australian intensive care practice, which may differ from that in other countries. It is intended as a supplement to the more specific information provided by the doctors and nurses caring for your loved one. ICNSW attests to the accuracy of the information contained here but takes no responsibility for how it may apply to an individual patient. Please refer to the full disclaimer.