What is Tunneled Central Venous Catheter Flushing Guide

It is important to wash out (flush) your tunneled central venous catheter each time you use it, both before and after you use it. Flushing your catheter will help prevent it from clogging.

How to flush your catheter

Supplies Needed

• A clean pair of gloves.
• An alcohol wipe.
• A 10 mL syringe that has been prefilled with saline solution.
• An empty 10 mL syringe (if a substance called heparin was injected into your catheter).

Flushing Your Catheter Before Use

If There Is Heparin in Your Catheter

1. Wash your hands with soap and water.
2. Put on gloves.
3. Scrub the injection cap for 15 seconds with an alcohol wipe.
4. Unclamp the catheter.
5. Attach the empty syringe to the injection cap.
6. Pull the syringe plunger back and withdraw 10 mL of blood.
7. Place the syringe into an appropriate waste container.
8. Scrub the injection cap for 15 seconds with an alcohol wipe.
9. Attach the prefilled syringe to the injection cap.
10. Flush the catheter by pushing the plunger forward until all the liquid from the syringe is in the catheter.
11. Remove the syringe from the injection cap.
12. Clamp the catheter.

If There Is No Heparin in Your Catheter

1. Wash your hands with soap and water.
2. Put on gloves.
3. Scrub the injection cap for 15 seconds with an alcohol wipe.
4. Unclamp the catheter.
5. Attach the prefilled syringe to the injection cap.
6. Flush the catheter by pushing the plunger forward until 5 mL of the liquid from the syringe is in the catheter.
7. Pull back on the syringe until you see blood in the catheter.
8. If you have been asked to collect any blood, follow your health care provider’s instructions. Otherwise, flush the catheter with the rest of the solution from the syringe.
9. Remove the syringe from the injection cap.
10. Clamp the catheter.

Flushing Your Catheter After Use

1. Wash your hands with soap and water.
2. Put on gloves.
3. Scrub the injection cap for 15 seconds with an alcohol wipe.
4. Unclamp the catheter.
5. Attach the prefilled syringe to the injection cap.
6. Flush the catheter by pushing the plunger forward until all of the liquid from the syringe is in the catheter.
7. Remove the syringe from the injection cap.
8. Clamp the catheter.

Problems and solutions

• If blood cannot be completely cleared from the injection cap, you may need to have the injection cap replaced.
• If the catheter is difficult to flush, use the “pulsing” method. The pulsing method involves pushing only a few milliliters of solution into the catheter at a time and pausing between pushes.
• If you do not see blood in the catheter when you pull back on the syringe, change your body position, such as by raising your arms above your head. Take a deep breath and cough. Then, pull back on the syringe. If you still do not see blood, flush the catheter with a small amount of solution. Then, change positions again and take a breath or cough. Pull back on the syringe again. If you still do not see blood, finish flushing the catheter and contact your health care provider. Do not use your catheter until your health care provider says it is okay.

Additional tips and information

• Have someone help you flush your catheter, if possible.
• Do not force fluid through your catheter.
• Do not use a syringe that is larger or smaller than 10 mL. Using a smaller syringe can make the catheter burst.
• Do not use your catheter without flushing it first, if it has heparin in it.

Contact a health care provider if:

• When flushing your catheter before you use it, you cannot see any blood in the catheter.
• Your catheter is difficult to flush.

Get help right away if:

• You cannot flush the catheter.
• The catheter leaks when you flush it or when there is fluid in it.
• There are cracks or breaks in the catheter.