Flushing IV sites?

  1. 1 If a patient is on continuous IV fluid, do you ever have to flush the line with NS? Or Heparin? Does you facility have a procedure on that or is it just general nursing procedure.

    Thank you for taking the time to respond.
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  3. Visit  nycNurse2b profile page

    About nycNurse2b

    From 'The Big Apple'; Joined Feb '04; Posts: 322; Likes: 25.

    15 Comments so far...

  4. Visit  CRNI(R) profile page
    1
    Quote from nycNurse2b
    If a patient is on continuous IV fluid, do you ever have to flush the line with NS? Or Heparin? Does you facility have a procedure on that or is it just general nursing procedure.

    Thank you for taking the time to respond.
    A continuous infusion would only require a routine/prn dressing change, a routine/prn rotation site of the access if peripheral, and tubing change.
    shahnaz likes this.
  5. Visit  canchaser profile page
    1
    Our hospital has a policy to flush with NS every 8 hrs. Running or not. Heparin is pretty much not used anymore that I've seen.
    shahnaz likes this.
  6. Visit  CRNI(R) profile page
    0
    Quote from canchaser
    Our hospital has a policy to flush with NS every 8 hrs. Running or not. Heparin is pretty much not used anymore that I've seen.
    So they require you to flush in order to document potency q shift? Makes sense.
  7. Visit  bjaeram profile page
    12
    Quote from canchaser
    Our hospital has a policy to flush with NS every 8 hrs. Running or not. Heparin is pretty much not used anymore that I've seen.
    So you stop your saline infusion to flush with saline???

    We don't flush continuous infusions, no point in that at all!
  8. Visit  ckh23 profile page
    0
    Quote from bjaeram

    We don't flush continuous infusions, no point in that at all!
    The point is to know if your line is still patent or not. Just because you are running continuous IV fluids does not mean it hasn't infiltrated. Same with central lines because the line could very well have migrated out.
  9. Visit  AggieNurse99 profile page
    1
    I guess our policy is not necessarily to flush q8h but to check for blood return q8h. Its just habit to flush after.
    shahnaz likes this.
  10. Visit  CVmursenary profile page
    11
    if there was a continuous infusion running and the line had infiltrated i think you could just tell by observing the site?
  11. Visit  Jenni811 profile page
    0
    No- we don't flush with running fluids. We assess the area for signs of infiltration, Some people only check it once a shift, i dont think it hurts to check it whenever you are doing someting with the IV (ex: changing a bag, hanging a secondary, changing tubing, clearing pumps, changing infusion rate etc.) You do so much with the IV's that i just look at it, ask if they are having any symptoms.
    But there really is no need to check patency if you have fluids running. Its not wrong to do it though.

    a little offf topic, but did you know those 10cc saline flushes are like $30-40 for one?? Crazy!! I was a patient once, i broke my left arm in 5 places so i needed surgery for rods placed. Anyway...nurse came in to check my IV patency, iwas saline locked. She had a student with her and was letting the student do it. I kindly asked if she would only flush with 5cc and save the rest for the next time someone had to check....hahaha, of all the ways to save a few bucks. Nurses don't make good patients.!
  12. Visit  iluvivt profile page
    3
    There is really no point in interrupting a continuous infusion to perform a routine flush unless you have a good reason to do so. That is just one more entry into the system and the trend now is to avoid any unneccesary entries into any IV system. Stopping a continuous PIV to check for a blood return and flush as a tool to assess for infiltration does make any sense and is not advocated by INS. You rather need to be assessing for swelling..coolness at site...pain..leaking at the catheter skin junction.. length of dwell time (the longer that it is greater chance of complications)things of that nature. A common misconception is that a blood return from a PIV is a sufficient indicator or assurance that your catheter is in the vein...THAT IS NOT TRUE. You may have a catheter that is partially in the vein and partially out and you will still get a good blood return . You need to check for a variety of things and always compare to the other arm. As far as a Central lines goes you do not need to stop and flush that either if a continuous infusion is going. I will stop an flush if I am hanging a new bag of TPN with Lipids as Lipids tend to build up and can occlude a CVC or if I really want to check for a blood return. As far as heparin goes....for PIVS..there is very little use of it now b/c back in the 90s they proved no difference in occlusions between NS and heparin on PIVS. For CVCs there is a huge difference and INS does advocate for a final heparin flush on CVCs. A NS pre-fill is a one time use product..it should not be recapped nor should that cap be used again on the end of IV tubing.
  13. Visit  mikeicurn profile page
    0
    Quote from canchaser
    Our hospital has a policy to flush with NS every 8 hrs. Running or not. Heparin is pretty much not used anymore that I've seen.
    Our facility has the same policy. Every IV, running or heplocked, get flushed and charted on q shift.
  14. Visit  cpilny profile page
    0
    While I would not see a need to flush a continuous IV, if you are going to piggy-back or push a drug on the line, always make certain the main line fluid is compatible with the piggy-back or IV push med. Some drugs will form a precipitate with certain IV fluids like D5. Better safe than sorry!
  15. Visit  bjaeram profile page
    0
    Quote from ckh23
    The point is to know if your line is still patent or not. Just because you are running continuous IV fluids does not mean it hasn't infiltrated. Same with central lines because the line could very well have migrated out.

    You assess for infiltration by assessing the site for pain, swelling, ect. Those symptoms will be present with a continuous infusion just as much as with a flush. If the infusion is running and the site looks fine you know the line is patent.


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