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Flushing CVC with less than 10ml normal saline

Is anyone using less than 10ml normal saline for flushing any central venous catheter?  The 2011 INS Standard 45, Practice Criteria D. states that "a minimum volume of twice the internal volume of the catheter system is recommended; however a larger volume may be needed for blood sampling or transfusion procedures." I will do a lit search but am interested in what volume others are using for flushing.

Before medication?

After medication?

Maintenance flush?

Is anyone experiencing an inability to obtain prefilled 10ml prefilled normal saline flushes from BD?



I researched the literature

I researched the literature for that standard on flushing and locking and am now in the process of doing it again for the SOP revision. There are no studies that have established an exact amount of saline for flushing any CVAD. The INS Flushing Cards state to flush with 5 or 10 mLs and this is based on consensus from the hospitals represented on the task force that wrote those cards. So you can use 5 mLs but I would still use 10 mLs at least when flushing after drawing a blood sample or given a transfusion. Also please never think that you can use a 10 mL syringe, flush with 5 mLs before the med is given, then use the second 5 mLs after the med. This is a huge mistake because these syringes are labeld as a one time use only. This is coming from the Safe Injection Practice s from the CDC. We may be seeing some easing of the saline shortage over the summer but it could last a little longer than that, but it will eventually go away. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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