Why do you need to flush normal saline before and after IV bolus administration?
Peripheral intravenous catheters (PIVC) are the most commonly used intravenous device in hospitalised patients. They are primarily used for therapeutic purposes such as administration of medications, fluids and/or blood products as well as blood sampling. Show
AimThe aim of this guideline is to provide an outline of the ongoing maintenance and management of the PIVC for patients in hospital, outpatient, and home healthcare settings. For information related to insertion of PIVC, please refer to intravenous access guideline . Nurses who are deemed competent in IV insertion could continue to insert PIVC in consultation with NUM/CSN’s. Definition of terms
AssessmentPatient and IV site assessments should be done on a regular basis. PIVC assessment includes:
ManagementAdministration of intravenous fluid, drug infusions or blood products a) Continuous infusion of IV fluids
Infusion Pump Pressure
If pump pressure exceeds the recommended limits, check the patency of the PIVC. b) Administration of bolus/loading doses: Administering drugs: Drugs administered via PIVC may be
The most appropriate method should be selected depending on volume of diluent required, patient condition, fluid balance and intended rate of delivery. Drugs administered via:
Attach a completed drug label detailing the drug, dose, diluent, volume of diluent, date, time and signature of the nurse and the staff who double checked. Access PIVC only after cleaning the access port and scrub the hub. For intermittent infusions, IV lines which are disconnected are to be discarded between infusions. Ensure the cannula is flushed with normal saline once the giving set is disconnected from the cannula. For Opioid infusion bolus refer to the specific guidelines: Children’s Pain Management Service (CPMS)(opioid infusion guideline) Administering blood products:
Flushing of PIVC’s
Change of PIVC dressing and securement of cannula:
Change of Extension sets
IV Fluid Considerations via Peripheral IV line Which Fluids and how much fluids to use
Labeling infusions:
Fluid bag and infusion changes:
Line changes
Table 1.Changing IV bags and lines Bag change IV line change No additives in infusion Every 7 days Every 7 days Additives in infusion Every 24 hours Every 7 days Lipid or lipid containing parenteral nutrition Every 24 hours Every 24 hours Blood products Every 4 hours Up to 12 hours Removal of PIVCs: There is no evidence for routine replacement of PIVC unless clinically indicated. PIVC’s should be maintained with regular assessment and documentation of complications.
Management of complications There are a range of complications that could occur with the presence of a PIVC in insitu. Some of these complications can be prevented by the correct use of aseptic technique for insertion and maintenance as well as assessing the device as indicated.
Companion Documents References
Evidence Table The evidence table can be found here. Please remember to read the disclaimer. The development of this nursing guideline was coordinated by Mercy Thomas, Nursing Educator, and approved by the Nursing Clinical Effectiveness Committee. Updated December 2018. Why is it important to flush the saline lock after medication bolus at the same rate as you would use while pushing the medication?Flushing the IV line at the same rate as medication delivery ensures that any medication remaining within the IV line is delivered at the correct rate, and avoids giving the patient an accidental bolus of the medication. Flushing the saline lock clears the medication from the device.
What is the purpose of flushing an IV lock before and after administering a medication?A saline lock can be used for continuous and intermittent short-term IV therapy. Flushing is performed: Before and after administering IV fluids or medications to assess placement and patency of PIV. After blood sampling.
Why is it important to flush IV?The flush at the end of the IV administration or blood sampling procedure prevents accumulation by intraluminal drug deposits or fibrin and a clean surface impedes attachment from microorganisms to the inner wall.
What is the purpose of flushing saline in a heparin treated line before collection of blood for coagulation test?You need to rinse out the catheter after every use. This is called flushing. Flushing helps keep the catheter clean. It also prevents blood clots from blocking the catheter.
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