Co workers are having a discussion about flushing a picc after saline infusion. At our facility all our infusions are given via pump with NS as primary. After all infusions, the picc lines are "flushed" using the IV pump with at least 50 ml of NS fluid from the 500 ml bag of NS.
The question has come up about whether or not another flush is needed using a prefilled 10ml syringe. A few say it is necessary, but why? The line was flushed with 50 ml sailne via the infusion pump prior to disconnecting.
Any thoughts?
I would want the Saline flush if not merely to continue the continuity of the process. So, lets say you forgo the saline flush after the administration of Normal saline. Then, you just disconnect and do not reconnect until the next infusion/flush is due, the catheter may be just fine, but what if it weren't saline that you used for your primary bag, what if it were D5W, because you just gave synercid, which is incompatible with NS, then is that nurse going to realize the importance of NOT merely Disconnecting and will they know the importance of clearing the line with NS? I think continuity is important for all to maintain the catheter's patency.
I would agree on the continuity and standardization part of the issue. D5W or any solution with a medicaiton should not be allowed to remain in the catheter lumen. There is another issue also, especially if you use a negative displacment needleless connector. You would need to clamp before disconnecting the line to prevent reflux. What happens when the nurse forgets this step? Also if you try to eliminate this saline flush after the med infuses, there is a chance that some might think there is no need to flush before the med. This would mean no chance to check for resistance or confirm a blood return so no patency assessment. 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