I have a client on IV Cipro BID(HOME CARE). His med is hung and goes through a central line. We are having a discrepancy as to whether we should flush with 10cc BNS, hang the med, flush with 10cc BNS, and cap the end ..then at night shift flush the line with 10cc BNS reconnect the IV to the central line run the med and flush with 10cc BNS and recap the end. Another nurse is flushing with 10cc BNS running the med and then withdrawing 10cc NS out of the IV bag port and flushing with that to maintain pressure in the line and avoiding toxicity by using too much BNS in a 24 hour period. Then yet another nurse is flushing with the 10cc BNS running the med and then flushing with the primary line of NS and clamping the central line while keeping it connected for the next nurse to use the following shift. Keeping the line TKO is not an option becasue there is a period of 4 hours where no nurse is in the clients home. So what is the best or recommended protocol for this.
I have not run the med yet myself. This is what I would do...flush with 10cc plain NS run the med flush with 10cc BNS and disconnect and cap it off. We do not have plain NS at the clients home but I am thinking I will order some today. Prefilled NS syringes. What is the rationale for the use of BNS anyways....I always see the hospital use NS not BNS. Should the IV line stay connected after the med is run or capped off..this client is always in bed so mobility is not a factor.
May 27, '08
Figured it out. We now have prefilled NS syringes. Flush line with 10cc NS hang med , disconnect flush with 10cc NS and cap end of IV line and hang up. Change all lines and bags q 24 hours as it is intermittent.
May 27, '08
What is BNS? I can't figure out the "B."
May 27, '08
BNS is bacteriostatic normal saline.
May 28, '08
You really should not be taking the NS from the IV bag, First thing is to use a cap on the end of the line whatever brand you have a lot of places now use positive pressure caps on all CVCs find out the kind you have b/c that will help me tell you how to flush it properly. First verify blood return and patency 10 cc NS is good.....hang the Cipro.......flush with 10 cc NS,,,,,use either pre-fills or draw up preferably preservative free NS......followed by Heparin if you are using it. You should not leave a bag connected even if shut off or use a volume in a bag to flush..... this should be done with a syringe to get a turbulent flush which cleans the drug out of the line and promotes patency. To complicate matters if you are using a nedative pressure cap your final flush should be a positive end pressure flush. If it is a positive pressure cap.. flush...disconnect and clamp if there is a clamp. Can not stress the importance of good cap scrubbing with alcohol
May 29, '08
Thanks..everything is worked out...we flush with 10cc syringes, prefilled NS, and use the pressure technique on our needless capped lines...and I do scrub vigorously with the alcohol swab on the ends.
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