I think that the language we use is important for adequate communication. If we are not using the same words to indicate certain actions, how can we understand each other? Or adequately communicate good practices to our patients? The 2016 Infusion Therapy Standards of Practice contains an expanded Glossary so we can enhance our communication with each other.
One area where there seems to much confusion is how we use the words “flushing” and “locking” for all VADs. The INS glossary defines
Flushing is done most commonly with normal saline, although a few drugs may be incompatible with saline. In that case, 5% dextrose in water is used to flush the drug from the lumen but saline should be used to flush out the dextrose as this will provide nutrients for growing biofilm.
Solutions for locking a VAD are expanding. Evidence now shows that either normal saline or heparin lock solution produces similar outcomes for locking a central VAD. One solution is not better than the other. Additionally, new antimicrobial lock solutions such as ethanol, citrate, and numerous antibiotic solutions are proving to prevent and treat catheter related bloodstream infection. All studies refer to these as “locking solutions”.
Different purposes, a variety of solutions, different volumes, and locking periods makes this an expanding and complex topic. So flushing and locking are not interchangeable terms. Using the correct word will enhance interprofessional communication.
Author: Lynn Hadaway
Lynn Hadaway has more than 35 years experience in infusion nursing and adult education. Her experience comes from multiple acute care settings, healthcare manufacturing, continuing professional education.