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20 mL for saline flushing

I am seeking your input on when you need to use 20 mL of saline for flushing a VAD. Please give me your feedback on any special circumstances, procedures, or patients when you have seen the need for 20 mL of saline flush. Thanks so much, Lynn


20ml of saline could....for

20ml of saline could....for some considered a therpeutic infusion.  Most CVC's will clear with less that 1 to 2 cc of fluid (excluding I-Ports which prime with about 3cc).

I know of no reason or rational to flush with a total of 20cc at one flush


Just my 2 cents!

Barbara Tinsley
20 ml flush

Lynn,  we always flush with 20ml of saline after we use the line for a blood draw, the rest of the time we use a 10ml flush

Barbara Tinsley

Nan Morris
20 ml flushing

We flush with 20 mls of saline after a blood draw from a CVC.  This is the recommendation on Mosby's Skills (this particular skill is taken from the AACN procedure manual for critical care [2011]), which our facility uses for most procedures.  In code situations, 20 mls is used after IVP epineprine doses; 20 mls is also used after adenosine administration.  We use 10 mls in other CVC situations and 2.5 mls in PIVs. 

jill nolte
Hey Nan

I hope you see this.  


I checked that book out from the library to dig a little deeper on the flushing policy.  The only item I can find so far is on page 752 talking about ports states to "Flush with an additional 10 to 20 mL of NS if the blood does not clear completely from the extension tubing." and this references Himberger J, Himberger L:  Accuracy of drawing blood through infusing intravenous lines Heart Lung 30:66-73, 2001.


Are there other any other places in the Mosby's book that you can recall?  The book covers a lot, it's probably in there and I've missed it, I'm hoping you'll recall more.



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