5 Reasons Why Saline Flushes Are Vital for Central Line Management
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Time to read 6 min
What are normal saline syringe flushes and what are they used for?
A normal saline syringe flush is a process that is used to clean out intravenous catheters, such as peripheral IVs and tunneled central venous catheters (CVC), also commonly referred to as central lines. Common types of central lines include Peripherally Inserted Central Catheter lines (PICCs) and implanted chest ports.
As someone whose father had leukemia, I watched my mother help my father with his normal saline syringe flush daily. Oftentimes, cancer patients undergoing chemotherapy will have a PICC line or an implanted chest port and the medical device will need to be flushed while at home using normal saline to keep the line clear. The process can be done by a healthcare professional, like a home care nurse, or anyone who has been trained appropriately to complete the procedure at home.
In this process, the normal saline flush syringe which typically contains a mixture of salt and water (0.9 percent sodium chloride) is connected to the needless connector or the “hub” of the IV line. Once the syringe is connected to the needless connector, the solution is flushed through the line. While the syringe is typically filled with 10 mL of solution, remember that your prescribing clinician will let you know how many mL you should be flushing for your personal needs, as children and some adults need a smaller or larger dose than the prefilled amount. From there, the SASH method is typically followed and recommended by clinicians. The goal of the SASH method is to allow the normal saline flush solution to flush out any medication and bacteria that are left in the line after the last treatment.
The SASH Method
SASH is an acronym that stands for:
S: Saline flush
A: Attach medicine
S: Saline flush
H: Heparin flush
The main goal of this method is to walk patients through the process of protecting their lines with saline flushes and heparin, as well as the correct way to give medicine. This method makes sure that your lines stay clear for your safety and comfort.
Why is it essential that central lines patients perform saline flushes?
Talk to your doctor or infusion nurse about how to maintain your PICC line using saline syringe flushes. For example, Emily, the co-founder of Mighty Well, was directed to flush her line in between every medication she was infusing. On days she was not infusing medications in her PICC, she flushed her line daily to keep the lines clear. Good hygiene and sterile practices are critical, as each time the line is accessed, there is a risk of further bacterial contamination. Here are a few reasons why PICC patients are directed by their clinicians to use normal saline syringe flushes:
If you have a central line, talk to your doctor or infusion nurse about how to maintain your central line using saline syringe flushes. For example, Emily, the co-founder of Mighty Well, was directed to flush her line in between every medication she was infusing. On days she was not infusing medications in her PICC, she flushed her line daily to keep the lines clear. Good hygiene and sterile practices are critical, as each time the line is accessed, there is a risk of further bacterial contamination. Here are a few reasons why people requiring central lines for their treatment are directed by their clinicians to use saline prefilled syringes :
1. To Keep the Line Unobstructed
Patients can have PICC lines in place for up to months or years at a time with various medications that go through the line within this period. With proper care and hygiene, PICC lines can be maintained for extended periods. Our co-founder, Emily, is a great example of this. She successfully maintained her PICC line for 18 months, the length of her treatment, without complications demonstrating what is achievable with diligent line care.
Over time, various medications going through the line can leave debris and residue that causes a build-up to block the lumens This can raise concern as any blockages will become a problem with future medication delivery as the lumens must remain patent for medications to be fully effective. Normal saline syringe flushes allow the lines to be cleared out before and after any new medications go through the lines which removes any debris, residue, or any other forms of blockages that may be present.
2. Preventing Blood Clots
Another concern with prolonged use of central lines is that the patient may develop blood clots. When the central line is placed, the regular flow of blood is interrupted to allow for medications to enter the bloodstream. This interruption can help allow the treatment of diseases through direct access to the bloodstream.
However, if the blood does not flow properly, this may lead to a buildup of blood cells which over time may become a blood clot. For this reason, central line patients should use a normal saline flush syringe after the lines have been used for medication infusion or blood drawing purposes to reduce the risk of blood clots.
3. Prevent infections
Similar to the way that patients are at an increased risk for blood clots when undergoing treatment through a central line, patients are also at a higher risk of infections from leftover residue and debris of medications that were not cleared out. The spread of bacteria in a central line may eventually contaminate the bloodstream due to the line having direct access to the bloodstream. Bacteria in the bloodstream may lead to various forms of infections which can have serious implications on your health. As a person whose immune system is already fighting off a disease or infection, it is crucial to take all preventative measures to put a stop to potential infections. Consequently, all central line patients should regularly do a normal saline syringe flush to clear any bacteria out of their lines.
4. Patient comfort
Aside from reducing the risks of complications, another reason healthcare providers suggest regularly keeping up with saline syringe flushes is to experience the highest level of comfort possible. If the central line is clogged up due to debris and residue from previous medications, this may cause the patient to feel a slight sensation of pulling as the new medications push their way through the tube. By flushing the lumens, the medications should be able to flow through the lines more smoothly without the patient risking the lines becoming clogged.
5. To Prevent Medicines From Mixing
Another reason why clinicians, vascular access and infusion nurses recommend normal saline syringe flushes is to keep medicines from mixing in the lines. Each time a medication is administered, there may be residue and debris left in the lines. Since some medications do not mix well, it is important to clean out the lines with saline each time medicine goes through the lines.
To ensure that you are taking the best care of your central line as possible, it is crucial to regularly complete normal saline syringe flushes as instructed by your clinician. normal saline syringe flushes can be completed at home provided that you have received instruction on the best care practices from a healthcare professional or nurse. Properly flushing a central line is essential to ensure line patency, prevent blood clots, prevent infection, and improve patient comfort.
Disclaimer: The content on this blog, including medical information and personal anecdotes from patients, is not medical advice. Readers should consult a qualified healthcare professional before making any medical decisions based on this content. This blog is for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment.
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