Pulsatile Vs. Continuous Flush

[MunoRN, RN]

How many Nurses use a pulsatile, or "push-pause" flush when flushing an IV- either central or peripheral? Whichever method you use (pulsatile or continuous) was this how you were taught, something you learned along the way, or is it something you do based on experience.

Just curious. (This topic came from another site that for some reason I can't post on, so if this seems redundant to those of you who frequent both sites, I apologize).

[MN-Nurse, ASN, RN]

How many Nurses use a pulsatile, or "push-pause" flush when flushing an IV- either central or peripheral? Whichever method you use (pulsatile or continuous) was this how you were taught, something you learned along the way, or is it something you do based on experience.

Just curious. (This topic came from another site that for some reason I can't post on, so if this seems redundant to those of you who frequent both sites, I apologize).

We were taught continuous in school. I have one preceptor who likes the pulsatile. My policy is to always do things the way my (current) preceptor does it. Keeps me out of dutch and I have no desire to argue-by-proxy among preceptors.

[xtxrn, ASN, RN]

I learned continuous, back when dinosaurs roamed the earth :) Over the years, with more IVP meds (vs IM or IVPB), and diluting some of them for a slower, more steady administration, I started doing more pulsatile (for the med and flushes). It also gave me more info about the condition of the SL/HL/IV- if I went into it with the intention of continuous, I had a different pressure with the 'push'.... if I did the pulsatile, it was slower- and gave me the chance to find problems without causing pain with firmer (though still not some 'blast' by any means ) flushes/pushes.

[cindyloowho]

Pulsatile for central lines, because it helps to more efficently clear them, and the lumen as well as vein can handle the pressure. Continuous for PIVs because the lumen is short and so pulsatile is not only unnescessary, but the pressure may be too much for the small peripheral vein. That is how I do it. Anyone agree or disagree???

[MN-Nurse, ASN, RN]

Pulsatile for central lines, because it helps to more efficently clear them, and the lumen as well as vein can handle the pressure. Continuous for PIVs because the lumen is short and so pulsatile is not only unnescessary, but the pressure may be too much for the small peripheral vein. That is how I do it. Anyone agree or disagree???

I try to keep the pressure between the two methods the same. The pressure is not increased in pulsatile, it is just stopped and started.

[wyogypsy, RN]

I agree with cindyloowho!

[LouisVRN, RN]

Also agree with cindyloo. Our policy for central lines is pulsatile.

[ckh23, BSN, RN]

I was taught continuous in school, but was taught pulsatile by an educator one day. Ever sense I have used the pulsatile

[Coffee Nurse, BSN, RN]

Our policy is pulsatile on central lines, as the turbulence is supposed to disrupt the formation of the biofilm inside the catheter. We are also supposed to flush with nothing smaller than a 5 mL syringe, to avoid the pressure generated in smaller barrels.

NB: I work with neonates and their tiny central lines, FWIW.

[ForeverQuestioning]

Our policies come from our IV therapy department, of which all the nurses are certified through the Infusion Nurses Society. Our protocol calls for the push/pause AKA pulsatile technique for all central lines and PICC lines.

[IheartICUnursing]

I was taught to use the pulsatile method (where I work we call it the turbulent flow method) only when flushing a central line after a blood draw- it helps clear the port of blood. Some nurses were doing it all the time, but as many times as we flush lines in the ICU, they were starting to get arthritis :)

[Anna Flaxis, BSN, RN]

Pulsatile for both CVCs and PIVs. We draw from PIVs in the ED, so I use pulsatile in order to better flush sticky platelets out of the lumen and preserve the integrity of the PIV in the event the patient is admitted.