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Central venous catheter - flushing

Description

You have a central venous catheter. This is a tube that goes into a vein in your chest or neck and ends at your heart. It helps carry nutrients or medicine into your body. It is also used to take blood when you need to have blood tests.

You need to rinse out the catheter after every use. This is called flushing. Flushing helps keep the catheter clean. It also prevents blood clots from blocking the catheter.

What to Expect at Home

Central venous catheters are used when people need medical treatment over a long period.

• You may need antibiotics or other medicines for weeks to months.

• You may need extra nutrition because your bowels are not working correctly.

• You may be receiving kidney dialysis.

• You may be receiving cancer medicines

Follow your health care provider's instructions on how to flush your catheter. A family member, friend, or caregiver may be able to help you with the flushing. Use this sheet to help remind you of the steps.

Supplies you Will Need

Your provider will give you a prescription for the supplies you will need. You can buy these at a medical supply store. It will be helpful to know the name of your catheter and what company made it. Write this information down and keep it handy.

To flush your catheter, you will need:

• Clean paper towels

• Saline syringes (clear), and maybe heparin syringes (yellow)

• Alcohol wipes

• Sterile gloves

• Sharps container (special container for used syringes and needles)

How to Flush Your Catheter

Before starting, check the labels on the saline syringes, heparin syringes, or medicine syringes. Make sure the strength and dose are correct. Check the expiration date. If the syringe is not prefilled, draw up the correct amount of fluid.

You will flush your catheter in a sterile (very clean) way. Follow these steps:

• Wash your hands for 30 seconds with soap and water. Be sure to wash between your fingers and under your nails. Remove all jewelry from your fingers before washing.

• Dry with a clean paper towel.

• Set up your supplies on a clean surface on a new paper towel.

• Put on a pair of sterile gloves.

• Remove the cap on the saline syringe and set the cap down on the paper towel. Do not let the uncapped end of the syringe touch the paper towel or anything else.

• Unclip the clamp on the end of the catheter and wipe the end of the catheter with an alcohol wipe.

• Screw the saline syringe to the catheter to attach it.

• Inject the saline slowly into the catheter by gently pushing on the plunger. Do a little, then stop, then do some more. Inject all the saline into the catheter. Do not force it. Call your provider if it is not working.

• When you are done, unscrew the syringe and put it in your sharps container.

• Clean the end of the catheter again with another alcohol wipe.

• Put the clamp on the catheter if you are done.

• Remove the gloves and wash your hands.

Ask your provider if you also need to flush your catheter with heparin. Heparin is a medicine that helps prevent blood clots. Follow these steps if you do:

• Attach the heparin syringe to your catheter, the same way you attached the saline syringe.

• Flush slowly by pushing on the plunger and injecting a little at a time, the same way you did the saline.

• Unscrew the heparin syringe from your catheter. Put it in your sharps container.

• Clean the end of your catheter with a new alcohol wipe.

• Put the clamp back on your catheter.

Other Care

Keep all the clamps on your catheter closed at all times. It is a good idea to change the caps at the end of your catheter (called the claves) when you change your catheter dressing and after you have blood taken. Your provider will tell you how to do this.

Ask your provider when you can shower or bathe. When you do, make sure the dressings are secure and your catheter site is staying dry. Do not let the catheter site go under water if you are soaking in the bathtub.

When to Call the Doctor

Contact your provider if you:

• Are having trouble flushing your catheter

• Have bleeding, redness, or swelling at the catheter site

• Notice leaking, or the catheter is cut or cracked

• Have pain near the site or in your neck, face, chest, or arm

• Have signs of infection (fever, chills)

• Are short of breath

• Feel dizzy

Also contact your provider if your catheter:

• Is coming out of your vein

• Seems blocked

References

Hamady M, Hakim W. Venous access and interventions. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 86.

Practice guidelines for central venous access 2020: an updated report by the American Society of Anesthesiologists Task Force on central venous access. Anesthesiology. 2020;132(1):8-43. PMID: 31821240 pubmed.ncbi.nlm.nih.gov/31821240/.

Schwartz S, Vo V, Lamuraglia GM. Postoperative management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 36.

Review Date: 9/30/2024

Reviewed By: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.