How to maintain/preserve an IV site?

[veegeern, BSN, RN]

Our facility protocol is to flush IV sites q 8 hrs with 3 ml NS if the site is not being used. We also flush with 3 ml NS before and after IV med admin.

Had a patient receiving multiple IV antibiotics. The patient's site was being moved about every 24-48 hours r/t infiltration and/or pain at the site. The night nurse passed on in report that a Nurse Anesthetist (spelling?) suggested periodically flushing the site with 50 ml NS to preserve the site.

Does anyone know if there is any evidence for this practice?

Thanks!

[AfloydRN, BSN, RN]

Never heard of it. I work ER/ ICU and if a pt needs heavy ABT therapy they get a central line( PICC). We flush heplocks w/ 3 cc's NS Q shift and it doesn't help if the heplock is in the A/C or another location with constant movement( joints).

[all4schwa]

50mL flush would take a long time to do, you'd have to put that on a pump. Then that would be like bolusing them (okay for some, but not for all). But on the same token, maybe the pt with the SL not holding up when it's only being used for ATBs could be ordered an IVF at KVO to prevent clotting around the cath.

[PANurseRN1]

What kind of abx.? Depending on what the pt was getting, maybe a peripheral line was not the best choice. Perhaps a PICC would have been better.

I have never heard of flushing with 50ml NSS.

[doingourbest]

Never heard of that. Are you not using Heparin 100u/ml after the saline? What state are you in?

[meownsmile, BSN, RN]

We dont use heparin in a peripheral site unless dr has ordered it. Normal saline only, but i do agree that a KVO iv might be a good idea if there is problems with clotting off. Sometimes depending on the patient and where the iv is there isnt really a lot you can do except secure it as best you can and maybe wrap it with some kerlix to keep any unnecissary bumping and jarring on the bed from blowing it.

[zacarias, ASN, RN]

I think the anesthetist with the "50 ml" flush recommendation is wanting to make sure ALL of the abx is out of the catheter . However, some abx can be very irritant and downright damaging to veins and so in this case, a central line (PICC) is absolutely indicated.

[wooh, BSN, RN]

When we're giving frequent abx, I almost always try to get some fluids at KVO. Gives a little bit extra of dilution when you're running the antibiotics, and keeps that vein open in between.

[veegeern, BSN, RN]

Never heard of that. Are you not using Heparin 100u/ml after the saline? What state are you in?

I'm in Georgia. Hep flush is only used for central lines in our facility. Saline flush only for peripheral IVs.

[veegeern, BSN, RN]

KVO fluids makes sense. Just had never heard of flushing with 50 ml saline. I have chosen to use 10 ml for certain abx and after phenergan. Thanks to everyone who replied!!

[GrnHonu99, RN]

I work in the ICU. If someone is getting multiple antibiotics they get a PICC. We sometimes run (depending on the pt) IVMF to KVO. We don't use heparin to flush lines xcept the Art line. NS only. We don't have protocol to flush qshift, however that's prob. bc we use them constantly. We have venigaurds that we put over our peripherals, they work pretty well and allow you to still see your site. Flushing with 50cc I would think you could blow your vein just from flushing rather quickly? Seems like a lot and is to pts who are FVO.