Weird question about pre and post IV drug injection flushes.

[ANH_RN]

I have a weird question. For drugs that I administer through a saline lock I always flush before and after the drug just in case anything is sitting in the SL that isn't compatible. Does everyone else do this? I ask because often I will have an LPN give me a med to draw and give IV and one flush. I think it seems better because what if you meet some resistance with the initial pushing of fluid through the IV and you end up pushing too hard and too fast? One time I was administering a piggy back antibiotic and I let some NS go through to flush it out of the line, then I unhooked the line. I did not flush afterwards for God knows what reason. Then I went to give some Solumedrol later on and forgot to flush BEFORE (geez). I told my charge nurse about it and she said not to worry because it wasn't enough to cause a precipitation. So how much does there have to be to create real problems???

I was just kind of curious what of you thought. Thank you, I hope it's not a dumb question.

[ririrain142]

There are no dumb questions. I don't worry about things being compatible, I worry about my saline lock being patent. I flush with 2 cc NS before and after meds. That's plenty to clear the line. So at my hospital, one flush is enough (we used 5cc NS posiflushes). If you are giving a IVPB, you flush the IV tubing with NS and just use enough to flush the saline lock as well, then you don't need to flush to saline lock separately.

[diane227, LPN, RN]

Flush before to make sure you clear the line and that the line is patent. Then always flush again. If you are giving an agent that will irritate the vein give it via the port that is far away from the iV site so it can dilute down more before it gets to the vein, such a Phenergan. If you are giving any type of caustic medication, please make sure the line is good before you give the med.

[ChristineN, BSN, RN]

I all ways flush with Saline before and after to assure patency. The only time I do not flush is if I'm giving a med that is incompatible with Saline. In this case I withdraw 3cc's of blood from the IV, and use that to flush.

[Ayvah, RN]

I all ways flush with Saline before and after to assure patency. The only time I do not flush is if I'm giving a med that is incompatible with Saline. In this case I withdraw 3cc's of blood from the IV, and use that to flush.

What med is incompatible with saline?

[iluvivt, BSN, RN]

there are a few...one of the IVIG brands we use is incompatible with NS and then we use D5w....What you are referring to is a common nursing pratice when administering through any locked VAD, It is called SASH

S...........Saline flush

A...........Agent....(your drug)

S...........Saline flush

H............Heparin...if you are using it

The initial saline does ensure patency as well as remove any residual drug left behind...and yes it may not take much for a precipitate to occur or a chemical or physical incombatability

[P_RN, ADN, RN]

If the saline lock has a slide clamp, I flush with most of the saline, close the clamp and then push the saline to fill the cap as I withdraw. The back pressure helps keep the lock patent.

[ChristineN, BSN, RN]

What med is incompatible with saline?

IV Valium is a big one that comes to mind.