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IV Flush Chart

IV FLUSH CHART
Type of IV Device	Pre-Use	Post-Use	Minimum Intervals for flushing each lumen (whenever lumen is "locked" with no infusion currently running):
Peripheral IV Catheter (length < 3 inches)	10 mL saline	10 mL saline	10 mL SALINE every 8 hours +PRN
Midline, PICC Subclavian or Jugular CVC Percutaneous insertion/non-tunneled Tunneled Catheter (e.g., Hickman®/Broviac® type) All Valved Devices - (all PASV® or Groshong® brand VADs) Note that valved products are available as Midlines, PICCs, Tunneled Caths & Implanted Ports	10 mL saline	10 mL saline Flush with 20 mL saline: after TPN or anytime there is blood in the catheter or IV tubing	10 mL SALINE every 8 hours +PRN Valved Implanted Ports: If accessed, flush as above. If not accessed, flush monthly with 20 mL of saline
Implanted Port (venous ports only)	10 mL saline	10 mL saline followed by 500 units heparin (5 mL of 100 units/mL)	If accessed & not in use: 10 mL saline followed by 500 units of Heparin (5 mL of 100 units/mL) daily. If not accessed: 20 mL saline, followed by 500 units heparin (5 mL of 100 units/mL) monthly.
Post Parenteral Nutrition, Blood Reflux, or Transfusion	Flush with 20 mL saline (Followed by heparin flush if indicated per device type and if not resuming infusion immediately.) Follow this protocol for Midlines and all central venous access devices regardless of the reason for blood reflux.
Dialysis or Plasmapheresis Central Venous Catheters	Protocols vary greatly. Obtain specific orders prior to flush or dressing change. Catheter care is usually managed by dialysis nurse only. Document assessment of the dressing routinely. Be sure that clamps are closed and needleless connectors are secure if they are outside the dressing.

Specific Prescriber's Orders are required for all flushes.

It is mandatory to apply an anti-reflux needleless connector to every lumen of every IV Catheter to minimize the risk of clotted IV catheters.

Scrub the needleless connector with alcohol prior to each entry.

Make all tubing or syringe connections via the needleless connector - never connect directly to the catheter hub.
Unless drawing blood culture from a catheter lumen then the needleless connector should be removed and culture should be drawn by connecting it directly to the hub of the catheter.