Sterile water, saline and/or dextrose, diluent/flush, 10 ml
HCPCS code
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
- Preparation:
- Gather sterile water, saline, and/or dextrose solution.
- Use sterile technique to prepare the flush solution.
- 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.
- 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.