to my knowledge there are no contraindications to doing either method of flushing. this is why you won't find a lot of literature that specifically talks about this. the main issue is that you don't try to push an obvious obstruction through the catheter that could result in pushing a clot into the patient's circulatory system, or use a syringe that is too small that creates large pressures in the catheter itself that will cause catheter rupture. our iv team advocated that any central lines, piccs in particular, be flushed with large amounts of saline solution if the patient was able to tolerate it. the reason is because the piccs have smaller lumens and are subject to getting occluded much more easily than a device that is larger and inserted by a doctor closer to the heart. we carried 20cc and 50cc syringes and flushed these ports with a minimum of 20cc of saline whenever we flushed, especially if we drew blood from a picc for labwork. we found that this kept these lines clear. still, it is difficult to troubleshoot for fibrin sheaths that form flaps around the distal ends of catheters. often, its takes a de-clotting procedure to dissolve them followed by fastidious flushing.
- halfway through this article is information on flushing. both methods, straight continuous, non-interrupted flushing and "stop-start" flushing are addressed.
- this is a short procedure pictorial of how to flush and change the caps on a picc line. however, at the very end is a nice little table that nicely summarizes the major problems that can occur with picc lines, what the likely cause is and what you can do about it.
- this is a chart that includes flushing guidelines, tubing and dressing changes for various types of central lines. unfortunately, it doesn't make a distinction with regard to "how" to perform the flush.
from the medical university of south carolina venous catheter tutorial:
- about flushing piccs. . .
- how do i flush a picc?