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daylily
(Lynn) - help with post IV push flush rate

I have been asked what is our policy in regards to the speed of a post IVP flush, (same rate as the med, slower, faster).  I searched our policy (we use Lippincott) and do not find what the rate of the post-flush should be, just a generic statement which does not mention rate of post-flush. 

I also reviewed the "Direct Injection" section in the 2010 INS Infusion Nursing book.  INS states direct injection requires only the time it takes to push the plunger of the syringe.  As you know, there are a lot of variables when delivering IVP medication, i.e. crimped IV, IVP thorugh a compatible infusing primary solution, through incompatible primary solution, length of tubing between the syringe connection and the venous system, amount of the med.

I am being asked for evidence as to why our policy is what it is (which is not specific).  Thoughts??

lynncrni
Are you asking about the rate

Are you asking about the rate of manually pushing the 10 mL of saline after you give a medication OR asking about the infusion rate for fluid that a medication is given through? If giving a saline push, this should be done with a slow, steady gentle rate without ever applying force. Rapid forceful flushing can cause catheter damage and infusion-induced catheter movement. For a fluid flow rate, this should always be prescribed by the LIP. If piggybacked into the prescribed fluids, the rate should be the prescribed rate. If piggybacked into normal saline also known as a carrier fluid, the rate could be established in your policy and procedure, or prescribed by the LIP. Infusion Nursing Standards of Practice state that KVO orders must specify an infusion rate. There is no rate established by research that would be capable of "keeping a vein open" for all patients in all circumstances. So a patient-specific rate is required to be considered a legal order. 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

daylily
Lynn, I'm talking about the

Lynn,

I'm talking about the rate the saline should be pushed (in a prefilled 3ml, 5ml, or 10ml syringe) after pushing the med.  As you know there is still med within the IV device and extension.

lynncrni
There are no standards for

There are no standards for this issue. It would totally depend upon the med in the tubing/catheter and the internal volume of the system. 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

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