Flushing Peripheral and Central Lines

Catheter Type			Solution		Strength			Frequency
Peripheral Vascular Access Devices (VAD)
■ Peripheral IV line		NS		N/A						3 mL daily and PRN
■ Midline catheter		Heparin		10 units/mL						5 mL daily and PRN
Peripherally Inserted Central Catheters (PICC)
■ Groshong PICC		NS					N/A		5 mL per lumen every 7 days and after each use
■ Per-Q-Cath (Pediatric VAD)		Heparin					10 units/ mL		2.5 mL (child) or 0.5 mL (infant) q 8h and after each use
Central Venous Catheters (CVC)
■ Valved-tip (no clamps)	NS					N/A				5 mL per lumen weekly and PRN
■ Open-ended (clamps)	Heparin					10 units/mL				5 mL daily and PRN
Implanted Port Catheters
■ Groshong Port-A-Cath		Heparin					100 u/mL				5 mL daily and PRN

Routine Care of Peripheral and Central Lines

■ Clamps: Open-ended catheters will always have clamps to prevent the backflow of blood and air embolisms. All openended catheters must be flushed with heparin to minimize fibrin collection and clot formation.

■ No Clamps: Valved-tip catheters do not have any clamps and require saline flushes—use positive-pressure flush technique.

■ End-Caps: Change the end cap(s) every 7 days or sooner if any blood, cracks, or leaks are seen.

■ Syringe Size: The smaller the syringe size, the greater the pressure in pounds per square inch (PSI); greater PSI increases the potential for catheter damage. Therefore, a syringe size of 10 mL or greater is recommended for all central-line flushes.

■ Positive Pressure Flush:To reduce the potential for blood backflow into the catheter tip, which promotes clot formation and catheter occlusion, always remove needles or needleless caps slowly while injecting the last 0.5 mL of NS.