Flushing IV sites?

CRNI(R) · Feb 28, 2011

If a patient is on continuous IV fluid, do you ever have to flush the line with NS? Or Heparin? Does you facility have a procedure on that or is it just general nursing procedure.
Thank you for taking the time to respond.

A continuous infusion would only require a routine/prn dressing change, a routine/prn rotation site of the access if peripheral, and tubing change.

canchaser, BSN, RN · Feb 28, 2011

Our hospital has a policy to flush with NS every 8 hrs. Running or not. Heparin is pretty much not used anymore that I've seen.

CRNI(R) · Feb 28, 2011

Our hospital has a policy to flush with NS every 8 hrs. Running or not. Heparin is pretty much not used anymore that I've seen.

So they require you to flush in order to document potency q shift? Makes sense. :yeah:

bjaeram · Feb 28, 2011

Our hospital has a policy to flush with NS every 8 hrs. Running or not. Heparin is pretty much not used anymore that I've seen.

So you stop your saline infusion to flush with saline???

We don't flush continuous infusions, no point in that at all!

ckh23, BSN, RN · Feb 28, 2011

We don't flush continuous infusions, no point in that at all!

The point is to know if your line is still patent or not. Just because you are running continuous IV fluids does not mean it hasn't infiltrated. Same with central lines because the line could very well have migrated out.

AggieNurse99, BSN, RN · Feb 28, 2011

I guess our policy is not necessarily to flush q8h but to check for blood return q8h. Its just habit to flush after.

CVmursenary · Feb 28, 2011

if there was a continuous infusion running and the line had infiltrated i think you could just tell by observing the site?

Jenni811, RN · Feb 28, 2011

No- we don't flush with running fluids. We assess the area for signs of infiltration, Some people only check it once a shift, i dont think it hurts to check it whenever you are doing someting with the IV (ex: changing a bag, hanging a secondary, changing tubing, clearing pumps, changing infusion rate etc.) You do so much with the IV's that i just look at it, ask if they are having any symptoms.

But there really is no need to check patency if you have fluids running. Its not wrong to do it though.

a little offf topic, but did you know those 10cc saline flushes are like $30-40 for one?? Crazy!! I was a patient once, i broke my left arm in 5 places so i needed surgery for rods placed. Anyway...nurse came in to check my IV patency, iwas saline locked. She had a student with her and was letting the student do it. I kindly asked if she would only flush with 5cc and save the rest for the next time someone had to check....hahaha, of all the ways to save a few bucks. Nurses don't make good patients.!

iluvivt, BSN, RN · Feb 28, 2011

There is really no point in interrupting a continuous infusion to perform a routine flush unless you have a good reason to do so. That is just one more entry into the system and the trend now is to avoid any unneccesary entries into any IV system. Stopping a continuous PIV to check for a blood return and flush as a tool to assess for infiltration does make any sense and is not advocated by INS. You rather need to be assessing for swelling..coolness at site...pain..leaking at the catheter skin junction.. length of dwell time (the longer that it is greater chance of complications)things of that nature. A common misconception is that a blood return from a PIV is a sufficient indicator or assurance that your catheter is in the vein...THAT IS NOT TRUE. You may have a catheter that is partially in the vein and partially out and you will still get a good blood return . You need to check for a variety of things and always compare to the other arm. As far as a Central lines goes you do not need to stop and flush that either if a continuous infusion is going. I will stop an flush if I am hanging a new bag of TPN with Lipids as Lipids tend to build up and can occlude a CVC or if I really want to check for a blood return. As far as heparin goes....for PIVS..there is very little use of it now b/c back in the 90s they proved no difference in occlusions between NS and heparin on PIVS. For CVCs there is a huge difference and INS does advocate for a final heparin flush on CVCs. A NS pre-fill is a one time use product..it should not be recapped nor should that cap be used again on the end of IV tubing.

mikeicurn, ASN, RN · Feb 28, 2011

Our hospital has a policy to flush with NS every 8 hrs. Running or not. Heparin is pretty much not used anymore that I've seen.

Our facility has the same policy. Every IV, running or heplocked, get flushed and charted on q shift.

cpilny · Feb 28, 2011

While I would not see a need to flush a continuous IV, if you are going to piggy-back or push a drug on the line, always make certain the main line fluid is compatible with the piggy-back or IV push med. Some drugs will form a precipitate with certain IV fluids like D5. Better safe than sorry!