Method for sealing intravenous catheter

Intravenous catheters are widely used in clinical medicine and can be used in a variety of treatment methods, so the sealing method is particularly important. If the sealing is improper, it will lead to various diseases such as phlebitis. There is a difference between pulse pipe flushing and positive pressure pipe sealing. People need to have a full understanding of this in order to better play its role and avoid the trouble caused by improper pipe sealing.

1. How to perform pulse pipe flushing and positive pressure pipe sealing?

Pulse flushing: Use a push-and-stop flushing method to create a small vortex of saline in the catheter, which helps flush out any remaining drugs in the catheter.

Positive pressure tube sealing: Since the vortex generated by pulse tube sealing can easily form a negative pressure state, when there is 0.5-1 mL of tube sealing solution left, push the tube sealing solution while withdrawing the needle (the injection speed is greater than the needle withdrawal speed) to keep the catheter in a positive pressure state during the needle withdrawal process.

Reminder: Positive pressure sealing technology must be used when sealing the tube to prevent blood from flowing back into the tip of the catheter and causing catheter blockage.

Connect the needle-free positive pressure connector: After the sealing solution is injected, remove the syringe first and then clamp the thumb clip.

Connect the heparin cap: leave the needle tip slightly inside the heparin cap, push the sealing solution with positive pressure, and withdraw the needle while pushing. The speed of pushing the solution is greater than the speed of withdrawing the needle. First close the thumb clamp and then withdraw the needle.

Paying attention to the above points when flushing and sealing the tube will greatly reduce the blood return during the retention period of the indwelling needle, extend the retention time, etc.!

How to choose the amount of flushing fluid?

According to INS guidelines, the minimum flushing fluid volume used is equivalent to twice the internal volume of the catheter system (catheter and attached devices).

Larger volumes of flushing fluid (eg, 5 mL for peripherally indwelling catheters and 10 mL for central vascular access devices) may remove more fibrin deposits, drug deposits, and other residues. Commonly used flushing liquid volume:

2. Catheter Type and Flushing Fluid Volume

Peripheral catheter 3-5 mL

PICC/CVC5-10 mL

Reminder: Factors to consider when selecting flush volume include catheter type, patient age, and type of infusion therapy. Transfusion of blood components, parenteral nutrition, contrast media, and other viscous solutions requires larger volumes of flushing fluid.

3. Are the requirements for sealing liquid and flushing liquid the same?

no the same.

The amount of sealing fluid required is 20% more than the internal volume of the vascular access and additional devices. Example:

20% more internal volume for catheter type

20 G peripheral indwelling needle 1.1 mL 1.30 mL

4FrPICC1.33 mL1.60 mL

Therefore, when sealing the tube with normal saline, the amount of sealing fluid is the same as the amount of flushing fluid; when sealing the tube with diluted heparin solution, 2-3 mL each time is sufficient.

Reminder: The INS recommends using a 10 mL syringe or an injector designed to reduce injection pressure (ie, a 10 mL catheter injector) to assess catheter function. Therefore, a 10 mL syringe should be selected when flushing/sealing the tube.