Flushing with NS

Asystole RN · Jul 21, 2010

Just wondering is this correct? (# of ml's flushed and the aspiration?) When you are pre-flushing a saline line with NS before giving an IV push med, do you flush with 1 ml then aspirate for blood, than flush 2ml (with first 10ml NS prefilled syringe). Next admin the push med at prescribed time, than connect 2nd prefilled syringe and flush with 3ml.

Not sure what you mean by a "saline line" but I am assuming you are referring to some type of central line.

Aspirate first to verify placement, then flush. 3ml is not adequete to flush a central line after aspirating blood...you will see this when you do it. You flush with the entire 10ml of NS.

Administer med.

Then connect second NS flush and flush 10ml using the pumping or stop/start method.

If you have infusion restrictions or it is a peds patient then flush with 3ml.

Is there a reason we can't just use the one prefille syringe, because there is enough in there for both flushes? Would that be considered unsterile because of the aspiration of blood that you do in the first flush??

You need the full 10ml of saline plus it is considered poor practice, opens the risk for infection.

Also, with central lines you always do the full 10ml flush of NS, because the tubing is longer right??..Before flushing would you instill 2-3ml than aspirate for blood, than instill the full amount in the syringe?
Thank you in advance for your help!! (sorry if my questions are confusing)

The catheter will typically only hold 2-3 ml of fluid volume, depending upon the size of the patient, lumen of cather, location of placement and what kind of central line you have....Port/PICC/IJ/TAC etc.

Aspirate, flush, administer, flush, lock.

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glovedgoddess · Jul 22, 2010

By "saline line" I meant "saline lock" oops!..I meant for saline locks do we only generally flush with 3 pre and post..cause 10 pre and post can add up if you are giving many meds?.

So for IV push through a infusion line that is infusing an incompatible solution, you would first stop the infusion-flush with 10ml normal saline-admin med over prescribed time-flush with normal saline-restart infusion. (correct??)..-> my confusion here is that than we are not doing the start/stop method with the running infusion (cause it's incompatible & stopped) to dilute the med you are administering. Because I know that you do this with a med is compatible with the running IV infusion->kink line-push-kink line let flush thru-push med-kink line let flush thru..contd. SOOOo...when you give a med that is incompatible with the running infusion solution do you have to make sure to dilute it before giving it??

-> Do you always just leave the infusion running if the solution is compatible with the med you are giving? using stop-start method?..for some reason I have never been taught the stop-start method. My instructor just taught me to stop the IV infusion running whether it was compatible or not, and admin the IV push med over the prescribed time. BUT it has come clear to me now that the med is not diluting this way!!! ouch!

AGAIN sorry for any confusion..im cleary confused myself!

glovedgoddess · Jul 22, 2010

Just to be clear I was taught about the flush prior and post giving med if iv solution running is incompatible**

Asystole RN · Jul 22, 2010

By "saline line" I meant "saline lock" oops!..I meant for saline locks do we only generally flush with 3 pre and post..cause 10 pre and post can add up if you are giving many meds?.

By saline lock are you referring to a peripheral IV? A physicians order must be present to flush any catheter. Most facilities have a standing order. Generally you flush with 5ml of NS, 3ml if Peds of fluid restriction.

So for IV push through a infusion line that is infusing an incompatible solution, you would first stop the infusion-flush with 10ml normal saline-admin med over prescribed time-flush with normal saline-restart infusion. (correct??)..-> my confusion here is that than we are not doing the start/stop method with the running infusion (cause it's incompatible & stopped) to dilute the med you are administering. Because I know that you do this with a med is compatible with the running IV infusion->kink line-push-kink line let flush thru-push med-kink line let flush thru..contd. SOOOo...when you give a med that is incompatible with the running infusion solution do you have to make sure to dilute it before giving it??
-> Do you always just leave the infusion running if the solution is compatible with the med you are giving? using stop-start method?..for some reason I have never been taught the stop-start method. My instructor just taught me to stop the IV infusion running whether it was compatible or not, and admin the IV push med over the prescribed time. BUT it has come clear to me now that the med is not diluting this way!!! ouch!
AGAIN sorry for any confusion..im cleary confused myself!

Having a hard time understanding what you are attempting to describe but from what I gather you have an IV fluid/med runnning continously and want to push a med?

You disconnect the fluid/med (whether compatible or not) and flush the peripheral IV or IV extension, note that I am not referring to the IV tubing. You then push your med (you did dilute the med as ordered correct?) over the prescribed time. Flush, then reconnect the IV tubing with the continuous infusion.

You do not push medications through infusion tubing, only the peripheral IV and/or extension unless otherwise directed.

The stop/start method is for central lines, not peripheral IVs.