IV Tubing not Flowing


Hi Allnurses Community, what's the best and easiest way to troubleshoot an IV that is not flowing?

If there are no kinks and the line is patent but the IV still does not flow, what's the best thing to do?

Thank you in advance!

5 Answers

iluvivt, BSN, RN

2,773 Posts

Specializes in Infusion Nursing, Home Health Infusion. Has 32 years experience.

When you have this problem you need to check the whole system and should always think of IV systems in this manner. There is not just one answer.

Start at the top of your bag:

  1. Is is spiked properly?
  2. Does it need a vent? If it does make sure the vent is open.
  3. Is the roller clamp open, by gravity, or by pump?
  4. Is it threaded properly in the pump? Close the clamp before opening if not automatic to prevent free flow.
  5. Follow the line down, is there a slide or clip clamp or stopcock impeding the flow? If so, open it.
  6. Check the cap/LAD (Leur activated device), if in use, is it secure?
  7. Check the site. Is the microbore extension set or microbore tubing pinched off (often happens with haphazard taping with the intima)?

Still not working? Disconnect at the site, and attempt to flush whatever VAD you have. If a PIV, assess the site to make sure you do not have an infiltrate and/or phlebitis or you are just wasting your time.

A bad site is a bad site. If site is positional, you can take off the dressing and pull back the catheter 1/8th and inch and re-secure. Any PIV in an area of flexion that you can not re-site, you can stabilize with an arm board. Yes still a recommendation even though not used enough. 

If the line will not flush then you have an occlusion in the line and need to take more action and that will now depend upon what kind of VAD you are dealing with.

Specializes in ER, progressive care. Has 7 years experience.

It could be positional (for example if the catheter is in the AC and the patient keeps bending their arm...) or if the pump says "air" in the tubing, which in that case you get rid of the air bubbles. Make sure the tubing is primed before you hook it up to the patient.

Specializes in Emergency/Cath Lab. Has 6 years experience.

Depends on what it is. Is it a drug like propofol that has the glass bottle that you forgot to open the air vent or do you need to spike it with a needle to help it flow? Do you need to attach a syringe to the secondary to pump the air in the cassette into? Disconnect everything and let it free flow out?

Depends on the situation a lot of time.

Specializes in ED. Has 13 years experience.

Is it primed? Is the pump not working or not programmed correctly?

FlyingScot, RN

2,016 Posts

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc. Has 28 years experience.

Check the clamps. Seems like a no-brainer but that often is the problem.