Smartsite (Alaris)

[cannulation]

This might be a silly question. Smartsite needle free access valve (not smartsite plus). I know how to use it i.e. clamp prior to removing syringe. But does a smartsite provide a positive pressure or neutral, do I need to provide positive pressure on my syringe when I get to the last 0.5ml when dealing with central venous access devices to prevent blood being drawn back in or does just clamping prior to removal have the same effect.

Thanks

[iluvivt, BSN, RN]

We use the regular smart site on some of our tubing...this is how I have instructed nurses to do it b/c it is not neutral displacement like a regular clave or positive like the smart site plus, which we used to use so you do need to perform positive end pressure flushing and you should remove the syringe with a tad bit still in it as you are pushing and disconnecting....it sounds like you have that down.......then you clamp any open -ended PICC or CVC will have a clamp as an integral part of their design if there is no valve in the catheter anywhere. Now on the positive displacement type....you never want to clamp and then disconnect b/c you lose the benefit of the disconnect of the flush when the action happens....so with these you flush disconnect and then clamp......remember to do a push pause pulsatile flush on all CVCs including PICCs....on the pivs with the smart site...i used to flush ..clamp and then disconnect as they did no clot off as frequently.

[cannulation]

Thanks that is how use the smartsite so I am right thanks for confirming this.

[iluvivt, BSN, RN]

You are welcome....even flushing is getting complicated.