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Metallic taste/nausea with saline flushes

Specializes in Oncology, Palliative Care.

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

Specializes in Critical Care.

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

Specializes in Pedi.

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

Specializes in Oncology, Rehab, Public Health, Med Surg.

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

DatMurse

Specializes in Hematology/Oncology.

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

Specializes in Oncology, Palliative Care.

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.

Edited by BiohazardBetty

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

Specializes in Oncology.

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.

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

DatMurse

Specializes in Hematology/Oncology.

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

Specializes in Oncology; medical specialty website.

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

Specializes in Infusion Nursing, Home Health Infusion.

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.

Broc

Specializes in Med-Surg.

The most recent study done from 2014, is the first to measure and compare taste and odour disturbances associated with 2 syringe preparations of NS in a pediatric population. The study [Full text] is here for those who wish to read it.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214577/pdf/cjhp-67-353.pdf

Authors concluded it "these disturbances have been attributed to the leaching of volatile substances into the NS from the plastic of the syringe." However the pathophysiology was not investigated in this study or previous cited papers. The authors stated the limitations in their paper and the direct of future research into this phenomenon.

iluvivt, BSN, RN

Specializes in Infusion Nursing, Home Health Infusion.

Thank you Broc I am going to post that study in out IVT office!

When I worked inpatient if my patients complained of that taste, I would pull up the saline from those 10 ml plastic vials and the patients always said they didn't taste anything!

OCNRN63, RN

Specializes in Oncology; medical specialty website.

I always get that metallic taste. In fact, I get it up in my sinuses. The other day my port was being uncooperative, but all of a sudden I got this rush of metallic taste up in through my nose. Piece of peppermint gum took it away.

NurseKate16

Specializes in Post-Surgical, Urology, Short Procedures.

I always thought the metallic taste was from the heparin flush? My patients complain at the end when I flush their port with heparin, and then again at their next treatment when I use saline to flush the port again (we were told this is because the old heparin is flushing through). Is that not the case? I never thought it was the saline.

marialsnd

Specializes in Oncology.

In my experience of having my port flushed, I definitely can taste the saline flushes but not the heparin flush. For the bed taste from the flush I either suck on wintergreen certs or chew gum, preferably cinnamon flavored. I didn't have luck with sour (such as lemon drops), but if it has a strong flavor, especially with a little bit of a bite to it, I don't notice the bad tasted.

This has been a great thread and very informative for me. I will recommend candy or mints for any patients who complain about the metallic taste. I actually had one patient who liked the taste, which was surprising to me, but hey, that's the beauty of difference!

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