IV Push med– do you always have to pull back for blood return? - page 6

I'm really confused. Some resources say to pull back on plunger for blood return before pushing med, while others say flush with saline and then push med (without mentioning a need to check for blood... Read More

  1. by   ~Mi Vida Loca~RN
    Quote from PsychNP2Be2017
    Shenanigans, Mi Vida! Pure shenanigans from you!
    I was tired and finally decided to call a spade a spade. I really did try to be diplomatic.
  2. by   JasonBuzestes
    Best practice is to pull back on the flush to check for blood return. Don't use the medication syringe because if you don't get good return, then you may need to waste that med.

    That said, check your hospital's policy on this. Also, this practice is for pushing through IV lines. Aspirating when giving an injection is a different story and can vary based on the med.
  3. by   NicuGal
    I just had a lengthy surgery and not one nurse checked for a blood return on any of the three PIVs I had. And guess what, they were all fine, until they burned when they flushed them. I am an extremely hard stick, and yes I had an IJ for a few days, but Inwould have personally smacked any nurse who tries to pull my IVs for no blood return, especially my hand ones. The 22 I had in my forearm did have a blood return when unlocked. There are other ways to assess an IV as I have well learned in the neonate world.
  4. by   Jickson001
    Have you never encountered lines that are good working lines but that you can't get blood return on?
  5. by   jackbeninja
    This is just a smidge unrealistic. Not every situation permits for best practice. I agree with you, that's the way it "should" be, but nothing is so simple. Small gauge IVs will rarely draw back even immediately after insertion and will still flush just fine. Ive had the IV team place peripherals and confirm with ultrasonography and the IV still won't draw back.

    I find that much of nursing is a compromise between best practice in the textbooks and reality on the floor. What care environment do you work in?
  6. by   Whatdayisit11to7
    Yes yes yes always check blood return or you may introduce a micro clot into the circulatory system. And yes yes yesss always use a NEW. STERILE. FLUSH.
  7. by   Libby1987
    Quote from IVRUS
    Who gives VANCO IV push? That is insane. Before the administration of ALL medications, especially vesicants, you MUST get a free-flowing blood return from the IV catheter.
    I completely misspoke re the method (again with pre coffee posting), Vanco is commonly supplied in an elastomeric device via PICC but nonetheless administered by laypersons who do not nor are instructed by any pharmacy protocol to assess for blood return prior to administration.