LINE MAINTENANCE

Vascular access devices, such as IVs and IOs, should be assessed for patency (i.e., flushed) prior to each infusion to assess catheter function and prevent complications. They are flushed after each medication administration with sufficient volume and appropriate rate to complete the medication administration and to reduce the risk of contact between incompatible medications.

- Minimum: Flush access site with Normal Saline (NS) every 8 hours. Use a minimum volume equal to twice the internal volume of the catheter system (e.g., catheter plus add- on devices), typically 5 mLs for peripheral IVs.13
- Best: Flush access site with NS every 4 hours.

If only half of a prefilled NS syringe is used and saved for later, it should be labeled with the time and date first used and only used on one casualty. It should be discarded after 24 hours. Ensure the syringe is capped in between uses to prevent contamination and infection.

If prefilled NS syringes are unavailable, draw up NS into an unused, empty syringe from a bag of NS using the needle access port. Ensure the needle access port on the NS bag is cleaned using alcohol prior to access.

Procedure to flush peripheral line

- Gather equipment.
- Using aseptic technique, clean the access port with an alcohol prep pad.
- Take prefilled 10mL syringe of NS and needle (if applicable) or attach syringe to port.
- With constant pressure, inject NS into the port to flush the catheter to ensure the line remains open.
- If resistance is met, gently use pulsating pressure on the end of the syringe until NS flows freely.
- Carefully observe the IV site and discontinue any IV line that causes swelling, pain, or redness.
- Detach syringe and dispose; place needle in sharps container (if applicable).