Coagulation and ivs

bobnurse · Feb 23, 2005

I'm a new grad and have a question about flushing peripheral IVs. I was taught in nursing school not to flush an iv if there is pressure when attempting to flush it because there could be a blood clot formed at the end of the cannula. So on one of my patients I couldn't get a hep lock to flush, so I called the iv nurse to look at it. She said she was able to get it to flush just fine. I know the cannulas can get bent and that makes them harder to flush, but what I am concerned about is the coagulation. How likely is it that by pushing against pressure I can push a clot into the blood stream and harm the pt? And what about when blood backs up into a hep lock and kinda stays there even when it's flushed? Could that cause coagulation or infection? These are questions I've wanted to ask our iv nurses, but a little too scared to look stupid...thanks for your help.

You should never use an intravenous device that does not aquire a blood return. This means if your catheter does not return blood, then you dont flush........Many times nurses say "Its in the vein," well sure it is, but is there a clot? Also, many times with geriatric patients the catheter size fills the entire vein lumen allowing no flow to pass around the catheter, thus no blood return. This is damaging to the vein..........

Blood should not back into your catheter if you are flushing with a positive pressure technique or using a posiflow device (positive pressure valve).

If you are not using a positive pressure valve, clamp the hep-loc during the last .10 to .20 cc's to provide a positive pressure within your IV system.

Blood in your IV tubing can cause infection, especially if there is dextrose in the solution.

terryalbright · Apr 19, 2005

I'm a new grad and have a question about flushing peripheral IVs. I was taught in nursing school not to flush an iv if there is pressure when attempting to flush it because there could be a blood clot formed at the end of the cannula. So on one of my patients I couldn't get a hep lock to flush, so I called the iv nurse to look at it. She said she was able to get it to flush just fine. I know the cannulas can get bent and that makes them harder to flush, but what I am concerned about is the coagulation. How likely is it that by pushing against pressure I can push a clot into the blood stream and harm the pt? And what about when blood backs up into a hep lock and kinda stays there even when it's flushed? Could that cause coagulation or infection? These are questions I've wanted to ask our iv nurses, but a little too scared to look stupid...thanks for your help.

I don't think those are stupid questions!

As far as the pressure on the lok while flushing, I will usually try to draw back first. If there is a LITTLE resistance when flushing, I don't worry but I wouldn't force it.

The small amt. of blood in the lok would be mixed with saline and unlikely to clot but if it did I don't think it would work. Since it is the patients blood, and the lok was applied using aseptic techniqye, I don't see infection as being a high risk since blood is normally sterile and any pathogens that might be present would be from the patient.

I would just keep an eye on the site, as usual.