Flushing a central line - page 2

We only get PICCs except one of my guys came back with a central. Of course, I have never been trained on one so have researched it. I have read that prior to flushing one is supposed to check... Read More

  1. by   SuesquatchRN
    Quote from FLArn
    A couple of the SNF's I worked at used private IV nurse companies to place midlines and PICCs because it was cheaper than sending the patient out for them. I thought yours might also 'cause we all know it's always about saving a buck!
    We only get them in that way. The most we'll do is place a peripheral line.

  2. by   SuesquatchRN
    Quote from Asystole RN
    Who is your main pharmacy or which pharmacy provides your IV meds?
    That's a thought. I'm going to get the DON to clarify procedure when I go in on Tuesday.
  3. by   iluvivt
    You can flush a bit with a few ml of NS and then check for your blood return...if you were getting true air and not just pulling back against the vacuum then maybe you did have a break in the system ( an air source such as a loose cap a hole in the central line). So check for that as well. A push pause technique was originally thought to keep the rate of occlusion low even though there is no research proving that has any benefit....NOW with more research on biofilm being done some experts believe that a slow and steady and smooth flush is the way to go!!!!! Also always make sure that you have a confirmed tip placement...you can have a malpositioned CVC that will still give you an awesome blood return
  4. by   billythekid
    Quote from AlmostABubbieRN
    Oh, that's a good one. I keep getting told to look in the manual. Can't find anything in there and it hasn't been updated since 1986.

    Thanks, all, for your input. I'g going to continue to flush the way I do a PICC. I don't know how much air I'm getting, but it always looks like I've got a big, honkin' bubble in there. That's a technical term.

    Referencing the manual can be tedious, and of course, is not hands-on. My suggestion would be to ask for clarification from the nurse educator on your floor or institution. If you've never been trained or inserviced with CVCs, it really isn't fair to expect you to empirically know what to do. Anytime I come across a piece of hardware I've never seen, I will check with the educator on the floor. If they're not familiar with it, they make it a point to investigate the hospital policy and educate the nurse on it. It's a win-win in that situation - you get an 'official' answer and the educator knows the answer for the next nurse who asks.
  5. by   steelcityrn
    The OP stated there is no STEENKIN SPECIALIST...lol
  6. by   netglow
    Yeah, and that big policy binder entitled, "Figure It Out Yourself"
  7. by   SuesquatchRN
    Quote from 2ndwind
    Yeah, and that big policy binder entitled, "Figure It Out Yourself"
    HA! Best title I've ever heard for it.
  8. by   jeseale123
    Can you tell me more about vacuums please? I flushed a patient's INT the other day just prior to connecting a 3 mL syringe with 0.5 mL of Ativan, and the Ativan was completely injected by itself even though it was a total of two separate doses.
  9. by   CelticGoddess
    Quote from netglow
    Yeah, and that big policy binder entitled, "Figure It Out Yourself"
    I'm familiar with that policy binder.
  10. by   IVRUS
    I am assuming that you drew up two separate doses into ONE syringe. That's the first mistake. One should not draw up both doses into one syringe, give a partial dose, then come back later to give the rest of the medication in the syringe. So, again, I'm assuming, but you flushed the line with a 10 ml barrel syringe, then gave the Ativan using a 3 cc syringe? That in theory is fine, as long as you did not detect any resistance when flushing, and you obtained a brisk blood return the color and consistency of whole blood BEFORE the Ativan. As far as the vacuum, were you using a stopcock?

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