From the Guidelines
The recommended amount and frequency of free water flushes for intravenous (IV) therapy is typically 3-10 mL of sterile 0.9% sodium chloride (normal saline) or sterile water for injection, administered before and after medication administration and at regular intervals for maintenance, with the frequency depending on the specific catheter type and patient factors, as supported by the most recent guidelines 1.
Key Considerations
- For peripheral IV lines, flushing should occur every 8-12 hours when not in active use.
- Central venous catheters generally require flushing every 8-24 hours depending on the specific catheter type.
- Before administering medications, a 5-10 mL flush helps ensure patency, followed by another 5-10 mL flush after medication to clear the line.
- For incompatible medications, a 10-20 mL flush between drugs prevents interaction.
Patient Factors to Consider
- Fluid restrictions in renal failure or heart failure may require adjustment of flush volumes.
- Larger-bore catheters may require increased flush volumes.
- Patient-specific protocols and facility guidelines should be followed, as recommendations may vary between institutions based on their specific policies and patient populations, as noted in 1.
Maintenance and Patency
- Routine flushing with saline after the completion of any infusion or blood sampling is recommended 1.
- To maintain patency of subcutaneous ports not in active use, a four weekly flush is recommended 1.
- For tunnelled cuffed catheters and PICC lines, a weekly flush is recommended 1.
From the Research
Normal Amount and Volume of Free Water Flushes
- The recommended amount and frequency of free water flushes for intravenous (IV) therapy is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, the studies focus on the prevention and management of catheter-related bloodstream infections (CRBSIs), which may be related to the maintenance and flushing of IV catheters.
Frequency of Free Water Flushes
- The frequency of flushing IV catheters is not directly addressed in the provided studies, but it is implied that regular maintenance and flushing of catheters can help prevent CRBSIs 3, 5.
- The studies suggest that the type of catheter, insertion site, and underlying patient conditions can affect the risk of CRBSI, but do not provide specific guidance on the frequency of free water flushes 2, 4, 6.
Volume of Free Water Flushes
- The volume of free water flushes is not specified in the provided studies, but it is likely that the volume used would depend on the type of catheter and the patient's individual needs.
- The studies emphasize the importance of proper catheter maintenance and removal of unnecessary catheters to prevent CRBSIs, but do not provide detailed information on the volume of free water flushes 3, 5.