At what rate should you flush with normal saline after administering IV medication?
There is a lack of standardised practice and national guidance to support flushing technique following administration of intravenous medicines. This article summarises new guidelines on post infusion flushing Show
Abstract Citation: Dix A (2021) Line flushing to prevent medicine loss after intravenous fluid therapy. Nursing Times [online]; 117: 5, 22-23. Author: Ann Dix is acting assistant practice and learning editor, Nursing Times. A saline lock (SL), also known as a heparin lock, is a peripheral intravenous cannula connected to extension tubing with a positive pressure cap (see Figure 8.7). This device allows easy access to the peripheral vein for intermittent IV fluids or medications (Perry, et al., 2014). The saline lock is “flushed” or filled with normal saline to prevent clotting when not in use. To use an SL, the cannula is flushed with 3 to 5 ml of normal saline to assess patency. After the saline lock is used, the cannula is flushed again with 3 to 5 ml of normal saline or heparin to “lock” the saline in the cannula in order to keep it patent. Once the saline lock is inserted, it can be left in a vein for up to 72 hours or as per agency policy. Saline locks are usually inserted in the arm or hand. If a saline lock is removed, the extension tubing and positive pressure cap are also changed (Vancouver Coastal Health, 2012). A saline lock can be used for continuous and intermittent short-term IV therapy. Flushing is performed:
A saline lock must be flushed in a specific manner to prevent blood being drawn into the IV catheter and occluding the device between uses. Checklist 69 describes the process of flushing an SL.
An SL can be converted to a continuous or intermittent IV to infuse fluids or medications. Prior to converting an SL to a continuous infusion, review the physician’s orders for type of solution, infusion rate, additives, and duration. IV solutions are considered a medication. Follow the seven rights x 3 when preparing IV solution. To convert a saline lock to a continuous IV, review Checklist 70.
Critical Thinking Exercises
What is the normal saline flushing rate after a drug is given?These guidelines suggest flushing the line with as little as 3-10 mL NSS after antibiotics and with as much as 20 mL after total parenteral nutrition (TPN).
How quickly should the saline following the medication be administered?Intravenous Fluid Therapy
The usual approach is to administer 20 mL/kg aliquots of isotonic fluid (e.g., normal saline) over 20 to 60 minutes, with frequent reexamination to determine the need for additional bolus administration.
When performing an IV flush which volume of syringe should you use?The literature suggests the volume of flush should equal at least twice the volume of the catheter and add on devices and a minimum of 2mL normal saline flush is recommended.
How many mL of normal saline should you use to flush a saline lock?The saline lock is “flushed” or filled with normal saline to prevent clotting when not in use. To use an SL, the cannula is flushed with 3 to 5 ml of normal saline to assess patency.
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