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Karen RN
flushing technique


In the Winter 2006 JAVA, you state on pg 227, that "the use of positive-pressure flushing techniques with a positive-displacement device negates the displacement mechanism and promotes blood reflux."  We are currently using the CLC 2000 cap and our rep told us that  it did not matter  if we used the positive-pressure flushing technique.  What flushing technique do you reccomend?  Straight flush or puch pause? 


Karen RN

The positive-pressure

The positive-pressure technique for flush involves clamping the line while still flushing the last bit of saline so that there is little or no blood reflux into the catheter upon disconnection of the syringe.  (This method is recommended when using negative displacement caps). When using the positive displacement device, if you clamp before you disconnect the syringe - the positive-displacement of the CLC2000 does not occur as this mechanism is activated upon disconnection of the syringe. So sounds like there is misinterpretation of the terms here.

If I may speak for Lynn since I have read her statements about this several times, she does not make a recommendation for push- pause as there is no evidence recommending this method and in fact may cause dislodgement of biofilm into the circulation from the increased turbulence that this method causes. (forgive any inaccuracies)

No need for forgiveness, you

No need for forgiveness, you stated my thought correctly. Your CLC sales rep is confused or misunderstood your question because all positive displacement caps will not function correctly if you use a positive pressure flushing technique.

 I also have never found any science to support the theory of the push-pause flushing technique but there is also no evidence that is causes harm by breaking off the biofilm. This is also a theory based on shear stress and biofilm. While the push pause method could be somewhat helpful to remove whole blood from the catheter lumen, there is no possible way that it can "clean" the catheter walls as some people think. 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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