Our hospital may soon go to POSITIVE PRESSURE end caps on both peripheral iv's and CAVD's .
Any advice on flushing techniques . We use pre-filled syringes but I 'm not aware if they are designed
to prevent syringe-induced reflux.
Maureen Amirhekmat RN, CRNI
submitted on July 19, 2010
I believe the caps are positive displacement devices, not pressure caps. The flusing technique we use is the pause flush and leaving approx 0.5 - 1cc in syringe
dsnyrn
Proper flushing for positive and neutral displacement injection caps is to unclamp, attatch syringe and flush all of the solution then detatch the syringe before clamping. Andea, I think you are describing a negative cap flush.
Valorie Dunn, RN, BSN, CRNI
Infusion Therapy Coordinator
St Elizabeth Regiona Health's Home Health Pharmacy
Lafayette, IN
Valorie Dunn,BSN, RN, CRNI, PLNC
There is no pressure generated by these connectors so positive displacement is actually the correct term to describe them. First check the specific type of prefilled flush syringes being used. Are these traditional syringe designs or one of the new designs that prevents syringe induced reflux? If you are using a traditional syringe, you should always leave a small amount of fluid in the syringe to prevent compression of the plunger rod gasket. Expansion of this gasket produces reflux when the hand is removed from this plunger rod. This reflux, along with the disconnection reflux may be too much for the positive displacement to overcome. So flush, then disconnect, then clamp for a positive displacement needleless connector.
For negative displacement NC - flush, clamp, then disconnect.
For neutral NC, the sequence for clamping and disconnection is not important for the functionality of the device.
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
How do I know if the flushing syringe I'm using is a "traditional syringe design"? It's a BD Posiflush. I always leave a little saline along with a little air in the syringe, never pushing all of the saline out even if I can't see any air. This was the way I was taught to flush, many moons ago.
Thanks,
Wanda
BD Posiflush syringes are designed to prevent syringe-induced reflux. So you can use all the fluid with this particular brand of flush syringe. 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