(CVC) Management Guidance - the Royal Cornwall Hospitals Trust ...

Standard Operating Procedure for Flushing Tunnelled Line (Hickman) CVC SOP2
Procedure
Equipment:
Rationale
To prepare for task
Sterile dressing pack, Hand cleanser, Non sterile
gloves, 10ml luer lock syringe, 10-20mls
0.9%Sodium Chloride flush, 2% Chlorhexidine 70%
Alcohol wipe x 2, sharps bin, secondary securing
dressing, care plan, prescription chart
1. Wash hands apply gloves and apron To reduce risk of cross contamination
2. Prepare sterile field and equipment Advanced preparation for task and reduce risk of contamination
3. Expose line and switch off any infusion and To allow easy access when sterile and reduce risk of infusion drips on sterile field. Note early signs
observe VIP/CCAT score
of phlebitis.
4. Clamp line and using ANTT disconnect any Allow access to port and reduce risk of contamination
infusion, seal giving set end with sterile Bung
5. Remove gloves, wash hands and apply sterile Reduce risk of contamination
gloves and apron.
6. Prepare flush using sterile gauze to open flush Reduce risk of contamination and maintain sterile filed
7. Using sterile gauze pick up clave end and clean Reduce risk of contamination
with wipe for 30 seconds and allow drying for at
least 30 seconds.
8. Attach syringe using luer locking system
unclamp line. Draw back if possible to test and
using a push pause technique flush the line with
10mls
Maintain a closed system and keep line patent by creating turbulence in order to flush line
thoroughly
(if line contains Heparin, dispose of amount drawn back)
9. Toward the last 1-2 mls clamp line but continue To lock the system under positive pressure reduce risk of backflow and clot formation
to flush
10. If Heparin is used, use only required amount To ensure line remains patent and Heparin is not used as a flush
to lock e.g. 2-3mls
11. Use second wipe to clean end as before Reduce risk of contamination
12. Apply secondary dressing if required Comfort
13. Dispose of all sharps and document action in Reduce risk of contamination to others and maintain continuous records
care plan
*PHNT and Royal Marsden guidelines
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