Name of the Procedure:

Common Name(s): Sterile Water, Saline, and/or Dextrose Flush Technical Term: HCPCS Procedure A4216

Summary

The sterile water, saline, and/or dextrose flush is a medical procedure used to clean and maintain the patency of intravenous (IV) lines or catheters. It involves injecting a small volume (typically 10 ml) of a sterile diluent or flush solution into the medical device to ensure it is free of blockages and functioning properly.

Purpose

Conditions Addressed:

• Ensures the IV line or catheter remains open and unobstructed.

• Prevents the formation of blood clots inside the device.

  Goals/Outcomes:

• To provide a clear path for the delivery of medications, fluids, or nutrients.
• To maintain the functionality of the IV line or catheter.

Indications

Symptoms or Conditions:

• Patients receiving IV therapy.

• Patients with long-term central venous catheters or ports.

  Patient Criteria:

• Any individual with a peripheral or central IV access device requiring maintenance.

Preparation

Pre-Procedure Instructions:

• Generally, no special preparation is needed.

• Ensure the patient has adequate hydration.

  Diagnostic Tests/Assessments:

• Inspect the IV site for signs of infection or infiltration.
• Verify that the catheter or IV line is correctly positioned.

Procedure Description

1. Preparation:
   • Gather sterile water, saline, and/or dextrose solution.
   • Use sterile technique to prepare the flush solution.
2. Flush Administration:
   • Attach the syringe containing the flush solution to the IV line or catheter.
   • Slowly inject the 10 ml of solution into the line, observing for any resistance.
3. Completion:
   • Remove the syringe and cap the IV line if not in use.
   • Document the procedure in the patient's medical record.

Tools/Equipment: Sterile syringe, flush solution, and antiseptic wipes.

Anesthesia/Sedation: Not required.

Duration

The procedure takes approximately 5-10 minutes.

Setting

The sterile water, saline, and/or dextrose flush can be performed:

• In a hospital setting.
• At an outpatient clinic.
• In a surgical center.

Personnel

Typically performed by:

• Registered Nurses (RNs).
• Licensed Practical Nurses (LPNs).
• Sometimes by trained healthcare assistants under supervision.

Risks and Complications

Common Risks:

• Minor discomfort at the insertion site.

  Rare Risks:

• Infection.

• Allergic reaction to the flush solution.

  Management: Monitor for signs of infection or adverse reactions and provide appropriate interventions as needed.

Benefits

• Ensures continued patency and functionality of IV lines and catheters.
• Prevents complications associated with blocked lines, such as infections and clotting.

Expected Onset: Immediate.

Recovery

Post-Procedure Care:

• Monitor the IV site for signs of infection or leakage.
• Ensure the patient remains comfortable.

Recovery Time: None required; normal activities can typically be resumed immediately.

Restrictions: Follow any specific instructions related to the patient’s overall treatment plan.

Alternatives

Other options include:

• Changing the IV site if patency cannot be maintained.
• Using heparin or other anticoagulant flushes for patients with a high risk of clotting.

Pros and Cons:

• Alternatives may provide longer-lasting patency but come with added risks like heparin-induced thrombocytopenia.

Patient Experience

During the Procedure:

• Patients might feel a brief sensation of cold or pressure as the flush solution is injected.

  Post-Procedure:

• Generally, no pain or discomfort is expected.

  Pain Management: Not typically necessary, as the procedure is minimally invasive and usually painless. If discomfort occurs, it is brief and mild.