Flushing IV site

Posted
by Floater In FL Floater In FL (New) New

I was reprimanded by an IV nurse at the bedside, after she observed me not flushing a peripheral IV site after I disconnected his NS infusion.

Can anyone explain why I need to us an NS flush to flush a IV site when they had NS running? I always flush after medications, ABX, etc. as I don't want to leave any medication in the J loop. But this just did not make sense to me.

Thank you in advance

londonflo

londonflo

Specializes in oncology. Has 45 years experience. 2,124 Posts

The flush is done to create turbulence in the IV catheter so that no blood remains in the J loop and catheter which can lead to clotting. Kind of like a toilet flush.

MunoRN, RN

Specializes in Critical Care. Has 10 years experience. 8,058 Posts

There's not really any reason to flush an IV with saline after getting a continuous IV flush from an infusion of saline.

Flushing, if done as a continuous push doesn't actually create turbulence, it creates laminar flow within the lumen leaving the fluid closer to the wall of the lumen stagnate, ie unflushed.

An IV pump, with the exception of a syringe pump, using a pulsatile or 'stop / start' flow which optimally flushes the IV.  Performing an additional flush only creates an unnecessary opportunity to contaminate the line 

londonflo

londonflo

Specializes in oncology. Has 45 years experience. 2,124 Posts

 

27 minutes ago, MunoRN said:

An IV pump, with the exception of a syringe pump, using a pulsatile or 'stop / start' flow which optimally flushes the IV.

The push-pause method mimics this and is the recommended method.

It is my understanding that if the nurse is present when the saline is infused and the pump stops, no flush is necessary. But if there is significant time lapse since the pump stopped, there is a possibility of blood reflux into the catheter. Sometimes on a medical-surgical floor it can be 20-30 minutes before an RN can get down to the room to discontinue the fluids. 

MunoRN, RN

Specializes in Critical Care. Has 10 years experience. 8,058 Posts

Just now, londonflo said:

The push-pause method mimics this and is the recommended method.

 

It is my understanding that if the nurse is present when the saline is infused and the pump stops, no flush is necessary. But if there is significant time lapse since the pump stopped, there is a possibility of blood reflux into the catheter. Sometimes on a medical-surgical floor it can be 20-30 minutes before an RN can get down to the room to discontinue the fluids. 

The pump's been beeping for 20-30 minutes before the RN gets to it?  That's a very poorly staffed med-surg floor.

londonflo

londonflo

Specializes in oncology. Has 45 years experience. 2,124 Posts

5 minutes ago, MunoRN said:

The pump's been beeping for 20-30 minutes before the RN gets to it?  That's a very poorly staffed med-surg floor.

Yes, but it is unfortunately a fact in many hospitals on general units. I read about it frequently here on AN. As a patient I have experienced it many times. The patient (far from the desk) hits the call light and says "my pump is beeping". The Clerk locates the RN and relays the message. The RN puts it on his/her mental list.