Hi All,
I notice in Standard 45, Flushing and Locking, it does not state to aspirate for blood to check patency. The practice criteria, namely E and G, do address this. I realize the practice criteria are guidelines and not standards. It states to aspirate prior to "administration of medications and solutions". My question is, does this apply to flushing when not giving a medication? If a catheter is heplocked, and you are performing your q12hr flush (saline and heparin), must you aspirate for blood? Providers in my facility are split on this, and I'd like to have evidence to support one side or the other.
Thanks in advance!
Jenn Marusich
Team Leader-Vascular Access Team
Are you talking about a multilumen catheter where one lumen is not required? Or are you talking about a catheter left in place and there is no infusion therapy prescribed at all. In the last situation, the catheter should be removed ASAP. This is part of the CVC bundle - daily assessment of the need for the catheter and removal as soon as it is no longer medically necessary.
For the other situation, there is no evidence based answer but it probably would not create a negative outcome if saline flush solution escaped into the SC tissue or mediastinum. The risk comes when there is no blood return and you continue to infuse a medication which could easily flow retrograde between the catheter wall and fibrin sheath until it reached the SC tissue. Or if the catheter has eroded through the vein, it would be infused into the mediastinum causing huge issues. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I am referring to situations where a medication is not going to be administered, but the line is to be flushed (we flush q12hr when not in use). So, if you are flushing the line, but not administering a medication infusion, does blood need to be aspirated? On occasion, we also have lines left in when not needed for medication every day (ex: using it for chemo). Should blood return be checked with each flush in that case? Also, do we teach families to aspirate for blood with every flush in the home setting? We send many patients home with PICCs that receive infusions in the clinic, but do not get medications at home. Thanks for your time.