[cherilee]

when flushing a central line, do you use a seperate syringe for blood return check? or can you use a saline syringe flush?

In a central line, how is the heparin port determined? is it by color?

What is the purpose of "coming out shooting" when flushing a line?
Is this after blood return check?

Is a mid line a central line?
Your answers are appreciated

[SeaCruiser]

I will do my best to answer your questions.. I was an IV therapy nurse for 15 years before I moved and now I am back to Med Surg nursing

The first thing I would suggest is to check your policies at the facility where you work.
I will tell you how we did these procedures where I worked. If I was just checking a line I would use my saline syringe and once blood appeared I would then flush. Now this is not the case if you are drawing a lab specimen. You don't have to draw a lot of blood to verify placement. Where I worked we then flushed with Heplock after the saline flush.

As far as the colored ports the general rule is the dark red port is the largest and would be used for blood draws and blood infusions. The other two can be used for fluids and or Heparin infusions.

Another word for "coming out shooting" is positive pressure. Maybe the best way to understand what than means is the opposite.. in other words negative pressure. You will find especially with needleless systems, if you just have a syringe inserted and withdraw it, it will create a suction that draws blood into the end of the line (the part you can't see within the patient) This can clot off the line. By pushing your flush in and creating a positive force you limit the possiblity of clotting off your line. Be sure to use the clamp if the line is not being used.

Please keep in mind that there are many different manufacturers of central lines. It is best to check the recommendationsfor the brands used where you work. For instance Groshung catheters have valves and you never should use Heplock, only saline for flushing.

A mid line is NOT a central line. It is a peripherally inserted catheter usually in the antecubital. It is usually threaded in Basilic or Cephalic vein 5 or 6 inches. So.. a mid line would not be apprpriate for central TPN.

Hope this helps..

Sea..

[Daytonite]

No you do not have to use a separate syringe for checking blood return as long you don't withdraw the blood all the way back into the syringe. The heparinized port of a central line is determined by who ever heparinzed it. It should be the smallest lumen and it should be noted in the nurses notes. I am assuming that what you mean by "coming out shooting" when flushing a line has to do with not creating displacement by blood in the distal tip of the central line. Your needle in the proximal port creates a small displacement of space that when withdrawn, by negative pressure, pulls blood into the distal end which could result in the formation of a blood clot that subsequently obstructs that line. Continuing to flush while withdrawing the needle eliminates that problem. So, does the doctor inserting a central line that has groshong tips.

There are links to web pages of information on central lines on Post #6 of this thread on the Nursing Student Assistance Forum of allnurses:

• http://allnurses.com/forums/f205/any-good-iv-therapy-nursing-procedure-web-sites-127657.html - Any Good IV Therapy or Nursing Procedure Web Sites