Clots

[ERRN324]

I recently graduated and I am currently working in a fairly busy ER. I imagine like most of the country, we draw all of our labs out of saline locks if we have one. However, it seems like some people don't flush, and when I come back later to start fluids or push meds, there is tons of blood sitting in the lock. Or sometimes, I can tell that it was flushed but there is still some blood that has been sitting in the lock. I have this fear that a clot will have formed in the lock or the actual catheter and when flushing I will throw a clot and give them a stroke or PE or something. Is this even possible? Am I just worrying to much? THanks.

[NotReady4PrimeTime, RN]

It's theoretically possible, yes. But the clot that you'd dislodge would be very small in most instances and thus unlikely to cause a stroke or PE. If you're worried about the amount of blood in the hub of the lock, you can always change it, aspirate blood to clear any clots from your catheter and then flush well with NS to clear the fresh blood. Maybe your unit educator could do a little in-service on the proper maintenance of saline locks...