Quote from missjune
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 return).
Also, is it ok to recap a saline syringe? Or do we have to use a new one for flushing afterwards?
Thanks so much for reading!
Central lines such as PICC lines and mid-lines should usually yield good blood return, and if they don't, I don't try to flush anything through them. That being said, I have seen many peripheral lines that I could flush through rapidly with the equivalent of two tons of pressure but they just. will. not. draw, with or without a tourniquet applied, and often times this has nothing to do with clotting. I usually flush some plain NS through a peripheral to ensure patency of a line because, even if it is "blown", a small amount of NS is usually easily reabsorbed into the system with no lasting effects. As for vesicants as noted by a PP, one would be silly to use one of these medications without first testing for a properly working IV, right? Right.
I have yet to see a policy in my facility that states that, even though fluids flow freely through a line and people are receiving therapeutic effect from medications, that because it will not draw, we have to restart the line. This would be just cruel to some populations with very few workable veins of which to speak (ex-IV drug addicts, little old grammas).
As for recapping and reusing flushes at a later time, this is bad practice. The flushes are sterile, meaning once you have broken the package and the seal, you have compromised sterility, meaning bacteria can begin to build. Use a new flush every time.