What's your method for flushing a line?

[Philly85]

Hi all,

Current nursing student who is curious about everyone's methods for flushing a line. I've seen some variations, with some nurses actually lightly palpating the area over the IV as the flush goes in and some not doing so.

The nurse I was with yesterday during clinical said he just relies on if pt feels any discomfort and if he feels any resistance, as well as visually seeing if there is any disturbance in the area as the flush goes in. Also, the one patient had a wrist IV and the surrounding area was all bandaged up, so he technically couldn't palpate even if he wanted to on that one.

So, to palpate or not to palpate, or does it matter? Thanks in advance for your insight!

P.S. Different question. Our one pt was getting Vanco IV and we had to give an IV push of Lasix. So, I stopped the infusion, flushed the line, pushed the Lasix, flushed the line again, then reconnected the Vanco and restarted the pump.

After I flushed the line the first time, my nurse just held my flush for me while I pushed the Lasix and then handed it back to me in order to flush before restarting the Vanco.

If I had been alone, could I have just put the original cap back on the flush and laid it down in between? Or would I use one of those green-topped caps that has alcohol? I forgot to ask him before I left and was just curious.

[ThatBigGuy]

1. I palpate most of the time. In general, real world practice, you'll have other cues to help you decide patency. I watch the patient's face for s/s of pain, but keep one eye on the tegaderm to make sure the IV isn't leaking or the vein blows.

2. Those green caps are nice, use when in doubt. That being said, I would just have used a new flush post-Lasix. Scrub the hub in between flushes and meds. My IV med administration looks like this: scrub, flush, scrub, med, scrub, new flush. It adds mere seconds to the time of administration, but you're pushing the Lasix slowly anyways, so you have the time.