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identify your patient what is your name sir James Smith what is your date of birth nineteen 1780 but explain the valsalva maneuver to the patient and have the patient demonstrate Im going to ask you to hold your breath and figure down as if youre having a bowel movement can you please demonstrate that wash your hands and put on gloves clamp and disconnect any IV that is running through the central line place the patient lying flat without pillows or in a slight Trendelenburg position if tolerated have the patient turn their head away from the catheter remove the old dressing to avoid dislodgement of the central line discard the dressing and gloves put on clean exam gloves remove the sutures if a catheter tip culture has been ordered cleanse the site thoroughly with ch G in a back and forth motion for a minimum of 30 seconds and then allow the site to dry instruct the patient to help take a deep breath and hold it in deep breath and very on sir gently withdraw the catheter while apply