Question: Is it necessary to "lock" a cvad with a neutral needleless connector? We are aware that the clamping disconnecting sequence is not important with a neutral connector.
Queston: Our definition of locking is: Withdraw syringe during the last 0.5mLs of locking solution while still maintaining positive pressure on the syringe barrel. Is that correct?
Thank you very much
That technique can actually only be accomplished with a blunt cannual and a split septum connector. When the syringe is luer locked to the needleless connector there is no way to "withdraw" the syringe. This is an old technique taught to fill the deadspace left by the large blunt cannula.
Leaving a small amount of fluid in the syringe actually depends upon the syringe in use and not the needleless connector. If you are using a traditional syringe filled by the nurses or your pharmacy, you do not want to completely empty the syringe because this causes reflux. The compression of the gasket on the bottom of the plunger rod in the syringe expands and pulls blood back into the catheter. So leaving a small amount of fluid prevents this from happening. If you are using a prefilled syringe bought from one of several manufacturers who fill the syringe with saline and hepain, many of these are designed to prevent the gasket compression. The primary brands that come to mind are BD, Covidien, and Excelsior, although I think there is at least one more.
So check to see which type of syringe is in use to determine if you will need to continue leaving a small amount of fluid in the syringe.
Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you very much. That completely clears that up. Makes perfect sense!
Thank you!