Flushing UAC lines

I have heard that some nurses on my unit "like" to pulse the flush.... but I do not believe there is evidence behind this. I think it is more personal preference, and their personal thinking that it mimics the HR. I agree with you that this seems like nonsense.

I share your concern with this subject, however, you must consider too the length of the tubing that you are flushing. If you are flushing a line, chances are 0.1 ml, or even 0.2 might not eject all of the medication/fluid out of the line. Although a ton of fluid is not necessarily the most optimum situation, it is the lesser of the two evils, the other being the fluid/medication is not adequately delivered.

I agree with BB. There is no evidence about flushing with a "pulse" rather than straight.

Also, we do not use our art line for anything other than monitoring MAPs and drawing labs, so when we flush, we flush only until all the blood that is in the tubing is back in the baby. Therefore the amount of fluid flushed in is minimal.

Our art lines have a KVO running to maintain patency.

The reason for a pulsatile flush or sometimes called a start stop flush or technique (and this goes for adults peds and neonates) is to properly clean the line as well as to prevent reflux of blood into the distal tip. The use ot positive displacement valves (sometimes called positive pressure valves..although this name is not technically accurate) will also prevent this reflux. Now here is a big reason to do it this way...not only can it prevent thrombotic occlusion...it can potentially decrese your patients risk for infection. Blood sitting in any CVC (clotted or not) does increase the pts risk for infection. So Infusion Nurses Society Standards or Practice reccommend this type of flush on all types of CVCS in all patient populations. This type of flush is also important with implanted ports d/t the desing of the portal chamber,where sludge can build up if not flushed in this manner.

The reason for a pulsatile flush or sometimes called a start stop flush or technique (and this goes for adults peds and neonates) is to properly clean the line as well as to prevent reflux of blood into the distal tip. The use ot positive displacement valves (sometimes called positive pressure valves..although this name is not technically accurate) will also prevent this reflux. Now here is a big reason to do it this way...not only can it prevent thrombotic occlusion...it can potentially decrease your patients risk for infection. Blood sitting in any CVC (clotted or not) does increase the pts risk for infection. So Infusion Nurses Society Standards or Practice recommend this type of flush on all types of CVCS in all patient populations. This type of flush is also important with implanted ports d/t the design of the portal chamber,where sludge can build up if not flushed in this manner. PS do not worry about the volume...you need this much to clear the line (should be preservative free by the way)...its better to keep your line patent and keep the infection risk as low as possible.