Question: Normal Saline flush

At our facility we use BARD Powerplus PICC’s, per policy we only use 10cc NS flush q 12 hours. My question is: lately we have had PICC’s from other facilities coming to us that are open ended with clamps, are we correct in doing NS flush on these PICC’s? Just want to make sure we are flushing correctly. M.D. 6/17/19

Answer: Normal saline flushing is accepted practice for PICC’s, both closed and open-ended. BARD PowerPICC is an open ended catheter, the Solo is a valved PICC.

More importantly the type of needleless connector you use on any intravenous device can control the flow and allow you to avoid clamping. Two anti-reflux NC are available that have flow control. Below are links to some articles that discuss the NC issues in regards to reflux, and other articles on flushing.Also, Vessel Health and Preservation: The Right Approach for Vascular Accesshhas been released through open access link. It also has a chapter on flushing and needleless connectors. Feel free to share!

Link to Quantitative Assessment of Reflux NC article

Link to In vitro evaluation of fluid reflux after flushing different types of needleless connectors

Link to Pulsative flushing as a strategy to prevent bacterial colonization of vascular access devices

Link to Pulsatile Flushing: A Review of the Literature

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