Hello and first of all sorry for my bad English. I am a nurse student in Italy and right now I am on my first year. So, to get to the point quick.. From what I have learned ,we use Saline flashes(3 to 5ml) before and after we administer a bolus medication via an iv line. The reason for that is to keep the line patent and free from blood clots, medicine, etc.
Now to get to my question. My(excellent) teacher has told me that you do that ONLY if the patient has a venous catheter without being connected to an iv bag,meaning without taking any iv fluids at the moment.Just a catheter itself on his hand without a bag solution.
But.. another teacher taught me to do flushes before and after bolus medicine administration not only to patients I mentioned above,but also to patients that they receiving iv fluids(lets say n/s, or ringers lactated or electrolytes or whatever it doesn't matter). My question is just WHY. Supposedly, the Saline flushes are used to keep the iv line patent, but if the patient is taking iv fluids this means that his line is, obviously, patent and I can just give the bolus medication without flushing before and after.
From a little research I did on the internet, I found that you are supposed to flush the iv line before and after bolus medicine administration to patients that are receiving a solution via a bag, just to make sure that INCOMPATABILITY between medicines and the solution won't happen.
THIS DOESN'T MAKE SENSE AT ALL. Let's say I do what the teacher has taught and what the internet articles advice.
So for example, I have a patient that right now, is receiving Ringers Lactated iv. 1) I stop the infusion,2) I flush,3) I give the bolus medicine 3)I flush again and 4)I start the infusion again.Did I prevent the possible incompatibility? Of course not!! The medicine and the solution are gonna meet and mix up inside his blood system/inside his veins literally the next second as soon as I let the Ringers solution to run again into his vein. So if the medicine I just gave is incompatible with the solution, incompatability will happen anyways, flushing or not flushing, the medicine will mix up with the solution inside his blood system in seconds.
This drives me insane cause I don't know what teacher to listen to. Personally, I think that we need to flush iv lines that are not connected to any bag infusion.The reason is to prevent blood clots.
I find it insane to flush an iv line that is connected to an infusion bag(N/S, dextrose etc it doesn't matter). The patient will not form blood clots, and speaking for incompatibility between medicine and solution.. It will happen inside his blood system flushing or not flushing.
I hope you all understand what I am saying and again, sorry for my bad English.