Discharge Instructions: Flushing Your Central Venous Catheter

You are going home with a central venous catheter. This is a small, soft tube that is temporarily put in a vein in your neck or chest. A central venous catheter is often used when someone needs medications or nutrition over a period of weeks or months. It takes the place of an IV (intravenous) line, which would need to be replaced every few days. You will need to care for your catheter to keep it clean and working well. This sheet covers the steps for flushing your catheter.

General Guidelines

• Find out the details of your catheter—the type, length, and size, and expected length of therapy. You can get this information from your doctor or nurse.

• Follow flush procedures to keep the catheter potent.

• Note how much of the catheter is exposed (from where it exits your skin) and tell the doctor if the length changes.

Gather Your Supplies

• Saline flush:

  • 25-gauge needle and 10 ml syringe

  • 10 ml bottle of saline

  • 3 antiseptic swab sticks

  • 3 alcohol pads

• Heparin flush (if needed):

  • Heparin in the amount prescribed

  • 25-gauge needle and 10 ml syringe

  • 3 antiseptic swab sticks

  • 3 alcohol pads

• Plastic bag

• Puncture-proof container to dispose of used needle and syringe (large glass jar that has a lid)

Wash Your Hands

• Wash your hands before touching any of your supplies.

• Turn on the water.

• Wet your hands and wrists.

• Use liquid soap from a pump dispenser. Work up a lather.

• Scrub your hands thoroughly.

• Rinse your hands with your fingers pointing toward the drain.

• Dry your hands with a clean cloth or paper towel. Use this towel to turn off the faucet.

• Remember, once you have washed your hands, don’t touch anything other than your supplies. You must wash your hands again if you touch anything else, such as furniture or your clothes.

Clean Your Work Area

• Put pets and children out of your work area.

• Clean washable surfaces with soap and water, and dry with a clean cloth or paper towel.

• Wipe surfaces that are not washable (such as fabric or wood) so that they are free of dust.  Spread a clean cloth or paper towel over your work surface.

• If you need to cough or sneeze, move away from your work surface.

• Wash your hands again using the steps for handwashing listed above.

• Place your supplies on the cleaned and dried work surface. Lay out your supplies in the order you will be using them.

Prepare the Syringe(s)

Note: Ask if pre-prepared syringes with saline and heparin are available for your home use. If not:

• Wipe the rubber top of the saline vial with an alcohol pad.

• Attach the needle to the syringe, being careful not to touch the bottom opening hub of the needle or tip of the syringe.

• Remove the needle cap.

• Fill the syringe with 10 ml of air for the saline flush.

  • If you are also using heparin, get a second syringe.

  • Fill the second syringe with air equal to the amount of heparin prescribed for your flush.

• Stick the needle into the rubber top of the saline vial. Push air into the vial.

• With the needle still in the vial, turn the vial upside down.

• Pull back on the plunger to withdraw 10 ml of saline. Be sure to keep the needle below the fluid level.

• Check for air bubbles. Hold the syringe straight up and tap the barrel of the syringe with your knuckles. The bubbles should go to the top of the syringe.

• Push out any air and extra fluid. The end of the plunger should be on the line next to the number 10 (ml) for saline.

• Take the needle out of the vial.

• If also using heparin, repeat the above process using the second syringe and filling it with the prescribed amount of heparin. Be sure to check for air bubbles.

• Put the cap back on the needle. Be careful. Don’t stick yourself.

• Put the syringe down.

Flush the Catheter

• Clean the injection cap on your catheter with the 3 antiseptic swab sticks. Let it dry completely. Follow with the 3 alcohol swabs. Again, let it dry completely.

• Take the cap off the needle.

• Unclamp the tubing above the injection cap if there is a clamp.

• Push the needle straight into the port on the injection cap of the catheter.

• Push the plunger slowly so that the saline goes into the port.

• Repeat the process for each port. You may have as many as three ports.

• Be sure to reclamp the tubing if a clamp is present.

• Repeat the above steps if you need to flush with heparin.

• After flushing the catheter:

  • Don’t recap the needle.

  • Throw the needle and syringe away in your puncture-proof container. When the container is full, take it back to your healthcare facility for correct biohazard disposal.

  • Discard any other materials in the plastic bag and dispose in the trash.

• Injection caps will need to be changed regularly. Follow the directions given to you by your home health nurse or doctor.

Follow-Up

• You will be followed closely by a home health nurse or other nurse.

• Make a follow-up appointment as directed by our staff.