[araujojr]

My patient had a PIV on the wrist. Is it okay to have some back flow of blood in the chamber or hub, not sure what it's called. My instructor flushed it with NS.

[JennaRN1006]

It does happen from time to time, that blood will flow back into the IV. Your instructor flushed it with NS to get rid of the blood. If the blood stays there, it will dry and most likely clot off the IV making it not useful (even when the pt is heplocked). Then the pt has to get stuck again for a new IV.

If you have to go use that IV line again for fluids or medications, it wont work. Some IVs have the clamp attached so you can clip it off. My hospital has a policy to flush the IV q shift.

[Daytonite]

Back flow of blood occurs when the pressure of the blood in the vein exceeds the atmospheric pressure exerted by the fluids in the IV line. This happens with normal movement of the arm by the patient. Is it OK? Well, the blood and the IV fluids are sterile. The problem with it is that blood cells can lodge in the nooks and crannies of the lumen of the IV tubing which is not completely smooth as well as any attachments to the IV tubing. Once that happens, blood cells tend to want to clump together as they have an affinity for each other when they are stationary. So, yes, it is appropriate to occasionally flush the blood out. Normal turbulence in the veins and eventually the vena cava where the blood ends up will break up any clumping that may have occurred in case you might be worried about pushing any clots into the patient; a clot would have occluded the IV line already making an IV push impossible. Something else that can be done if the IV is running by gravity is to increase the external pressure on the IV line by raising the IV bag higher, but this won't work with an IV pump. With an IV pump you would need to increase the flow rate and that isn't kosher as you might forget to return it to the ordered rate of flow.