Peripherally inserted central catheter - flushing

Follow your health care provider's instructions on how to flush your catheter. A family member, friend, or caregiver may be able to help you with the flushing. Use this sheet to help remind you of the steps.

Your provider will give you a prescription for the supplies you will need. You can buy these at a medical supply store. It will be helpful to know the name of your catheter and what company made it. Write this information down and keep it handy.

To flush your catheter, you will need:

• Clean paper towels
• Saline syringes (clear), and maybe heparin syringes (yellow)
• Alcohol or chlorhexidine wipes
• Sterile gloves
• Sharps container (special container for used syringes and needles)

Before starting, check the labels on the saline syringes, heparin syringes, or medicine syringes. Make sure the strength and dose are correct. Check the expiration date. If the syringe is not prefilled, draw up the correct amount.

You will flush your catheter in a sterile (very clean) way. This will help protect you from infection. Follow these guidelines:

• Wash your hands for 30 seconds with soap and water. Be sure to wash between your fingers and under your nails. Remove all jewelry from your fingers before washing.
• Dry with a clean paper towel.
• Set up your supplies on a clean surface on a new paper towel.
• Put on a pair of sterile gloves.
• Remove the cap on the saline syringe and set the cap down on the paper towel. Do not let the uncapped end of the syringe touch the paper towel or anything else.
• Unclip the clamp on the end of the catheter and wipe the end of the catheter with an alcohol wipe.
• Screw the saline syringe to the catheter to attach it.
• Inject the saline slowly into the catheter by gently pushing on the plunger. Do a little, then stop, then do some more. Inject all the saline into the catheter. Do not force it. Contact your provider if it is not working.
• When you are done, unscrew the syringe and put it in your sharps container.
• Clean the end of your catheter again with a new wipe.
• Put the clamp on the catheter if you are done.
• Remove the gloves and wash your hands.

Ask your provider if you also need to flush your catheter with heparin. Heparin is a medicine that helps prevent blood clots.

Follow these steps:

• Attach the heparin syringe to your catheter, the same way you attached the saline syringe.
• Flush slowly by injecting a little at a time, the same way you did the saline.
• Unscrew the heparin syringe from your catheter. Put it in your sharps container.
• Clean the end of your catheter with a new alcohol wipe.
• Put the clamp back on the catheter.

Keep all of the clamps on your catheter closed at all times. It is a good idea to change the caps at the end of your catheter (called the "claves") when you change your dressing and after blood is drawn. Your provider will tell you how to do this.

Ask your provider when you can shower or bathe. When you do, make sure the dressings are secure and your catheter site is staying dry. Do not let the catheter site go under water if you are soaking in the bathtub.

Contact your provider if you:

• Are having trouble flushing your catheter
• Have bleeding, redness, or swelling at the site
• Develop swelling in the arm below the catheter
• Notice leaking or the catheter is cut or cracked
• Have pain near the site, or in your neck, face, chest, or arm
• Have signs of infection (fever, chills)
• Are short of breath
• Feel dizzy

Also contact your provider if your catheter:

• Is coming out of your vein
• Seems blocked

PICC - flushing

Hamady M, Hakim W. Venous access and interventions. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 86.

Beekmann SE, Henderson DK. Infections caused by percutaneous intravascular devices. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 300.

Schwartz S, Vo V, Lamuraglia GM. Postoperative management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 36.

Updated by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.