To Aspirate or Not

1940Nurse · Jun 22, 2006

Hello, Dialysis Nurses;
A question for you. When you flush a Tessio catheter do you pull back - aspirate couple cc's of blood and mix it into the final flush? Why or why not?

Are you talking at termination of treatment?

IF so NO. You are flushing the cath with saline and then instilling heparin to prevent the catheter from clotting before the next treatment. You don't want blood in the lumen per se.

km5v6r, EdD, RN · Jun 22, 2006

Hello, Dialysis Nurses;
A question for you. When you flush a Tessio catheter do you pull back - aspirate couple cc's of blood and mix it into the final flush? Why or why not?

In a word NO! Once the treatment is completed and the blood returned; the catheter should be flushed with saline then have the appropriate amount of heparin instilled. The clamp is closed while that last bit of heparin is pushed in to create pressure in the line to prevent blood from backing in. All of the flushing should also be done with the syringe screwed directly onto the catheter rather then through the cap. Flushing with saline then aspirating blood back before instilling the Heparin defeats the whole purpose of flushing in the first place and will only cause clotting of the line. One thing to be sure of when dealing with the Tessio/Schoen catheter is that enough Heparin is being instilled to compensate for the end segment. The last company I worked for had us add 0.7-1 ml of Heparin to whatever load was printed on the catheter. The end segment with the clamp and cap is placed on the Tessio catheter after the catheter has been tunneled and exits the skin. Makes it nice in that the catheter can be trimmed and the end replaced incase of cracks.

Hope this helps.

jnette, ASN, EMT-I · Jun 22, 2006

Agree with all the above. :)

But if you are flushing at the BEGINNING of treatment, then yes, it's perfectly fine or even preferable to asspirate first before pushing the saline. (after first removing the heparin blocks, of course!)