Metallic taste/nausea with saline flushes

[BiohazardBetty]

Is there anything y'all can suggest to decrease the metallic taste my patients experience when their central lines are flushed? Almost all of my chemo patients say they can taste it, but today I had a patient who vomited for nearly 2 hours after his port was accessed! Then he refused nausea medicine because he knew it would have to be mixed in saline. He said it doesn't matter how slow its pushed, he always at least is nauseous when his line is flushed with saline.

Can I access the port with just a heparin flush instead of a saline flush? Does it still taste the same if I draw it up from a bag or vial of saline? He said sucking hard candy doesn't help... A seasoned nurse told me to try a Kleenex sprayed with some smell the pt likes may help??

[MunoRN, RN]

This is supposedly due to the components of the flush solution being excreted into the lungs which then causes the patient to taste or smell those components on exhalation.

Many medications are also compatible with D5W, maybe that would be a better flushing option for that patient.

[KelRN215, BSN, RN]

Maybe he needs to take PO zofran or put a scop patch on before he comes to his clinic visits. I did once have a patient who would vomit if her lines were flushed "too fast." Like she'd wake up from a dead sleep and vomit if you flushed her line while she was sleeping.

[NanikRN]

Jolly ranchers for the metallic saline push taste--my chemo pts used to swear by it

[DatMurse]

some people have said that the preservative free saline. like the ones in the bottles or bag do not cause it. I dont know, I havent had a central line and saline flushes before.

ONS has an article.

The Case of the Sour Saline | ons connect

[BiohazardBetty]

some people have said that the preservative free saline. like the ones in the bottles or bag do not cause it. I dont know, I havent had a central line and saline flushes before.

ONS has an article.

The Case of the Sour Saline | ons connect

Thank you so much for posting this article!! I'm going to try Jolly Ranchers today & if it works, maybe we can get a budget to keep them on the unit for everyone else with the same problem.

[Summer7985]

I have flushed IV's and had my own flushed many times and I have been able to taste the alcohol swab when it's flushed. I have had many patients ask me what the taste is as well. Maybe wait a good 60 seconds for the alcohol to completely dry? See if that helps. I don't know if that's what's causing it, but maybe it will help.

[danceyrun]

This is often time consuming, but sometimes if I have these patients I will take some empty 10 ml syringes and make my own flushes from NS bags. It has helped. If you do this, ALWAYS LABEL your syringes.

[esrun2015, MSN, RN]

I have patients with peripheral lines tell me the same thing, not all but some of them.

[DatMurse]

I have patients with peripheral lines tell me the same thing, not all but some of them.

When were were practicing IVs on eachother. I was flushing my friend with it. He said "I taste it! ugh!" I just pushed it faster when he said that.

[OCNRN63, RN]

Jolly ranchers for the metallic saline push taste--my chemo pts used to swear by it

Yes, usually something tart does a good job of masking the taste.

I almost always taste it; in fact, I even smell it as it's being flushed. I try to remember to keep something in my purse for when I go for labs/port flushes.

[iluvivt, BSN, RN]

The pre-filled Normal Saline can cause a metallic taste much more so than if you draw it up from a vial of NS per my experience. I would immediately stop using the pre-fills of NS on this patient and either draw up my own NS from a small bag of Saline and then label it and this is frowned upon you can ask pharmacy to draw it up in the pharmacy for you an explain why. Try one intervention at a time to see what helps.