What can be used to flush Special Procedure Contrast (SPC)?

From the Guidelines

To flush a central venous catheter, sterile 0.9% sodium chloride for injection should be used to flush and lock catheter lumens that are in frequent use. This is based on the ESPEN guidelines on parenteral nutrition, which state that most central venous access devices for PN can be safely flushed and locked with saline solution when not in use 1. The guidelines also recommend that heparinized solutions may be used as a lock, after flushing with saline, when recommended by the manufacturer, in the case of implanted ports or opened-ended catheter lumens which are scheduled to remain closed for more than 8 h. However, the use of heparinized solutions is not recommended for routine flushing of central venous catheters, as three different meta-analyses of randomized controlled trials have concluded that intermittent flushing with heparin is no more beneficial than flushing with normal saline alone 1.

Some key points to consider when flushing a central venous catheter include:

• Using sterile 0.9% sodium chloride for injection to flush and lock catheter lumens that are in frequent use 1
• Flushing the catheter with saline before heparinization, if heparinized solutions are used 1
• Avoiding the use of heparinized solutions immediately before or after the administration of lipid-containing PN admixtures, and instead using a saline flush 1
• Following the manufacturer's instructions for flushing and locking implanted ports or opened-ended catheter lumens 1

It's also important to note that the frequency of flushing and locking central venous catheters may vary depending on the type of catheter and the patient's individual needs. For example, close-ended valve catheters should be flushed and locked with saline only, according to the manufacturer's instructions 1. Additionally, the use of needle-free connectors may help to prevent catheter occlusion, but more research is needed to fully understand their effectiveness 1.

Overall, the key to effective flushing and locking of central venous catheters is to use sterile saline solution and to follow the manufacturer's instructions and established guidelines, such as those from ESPEN 1.

From the Research

Flushing Solutions for SPC

To flush spc (single peripheral catheter), various solutions can be used, including:

• 0.9% sodium chloride (normal saline) 2, 3, 4, 5
• Heparin solution 2, 3, 4, 6
• Thrombolytic agents 2
• Antibiotics and chelating agents 2

Flushing Techniques and Volumes

Different flushing techniques and volumes can be employed, such as:

• Continuous syringe pressure 5
• Push-pause technique 5
• Pre-filled syringe 4
• Flushing volumes of 3 mL 6 or 5 mL 5

Considerations for Flushing SPC

When flushing spc, it is essential to consider the following:

• The type of catheter and patient condition 2
• The risk of occlusion and infection 3, 4
• The potential benefits and harms of different flushing solutions and techniques 3, 6
• The need for standardized flushing protocols and education for nurses 5