Flushing the Line Between Medications in IV Administrations of Multiple Agents

The article “Protocols for concomitant infusions in the same IV line” had a brief mention of using the IVPB method to administer premeds and chemotherapy.¹ When infusing a drug such as doxorubicin, the need to flush residual medication from the line is very clear by the bright red color of the drug. But most of our IV medications are clear and colorless, so the need to clear the tubing is not so obvious. What factors should be considered when calculating an adequate postmedication flush to deliver complete, accurate doses of small-volume IV medications to our patients? There seems to be a wide range of variability across many practice settings.

—Beverly King, BSN, RN-BC

Administering an IV flush between intravenous medications is critical to prevent incompatability issues between medications from affecting IV line patency or the integrity of the individual medications. In addition, the solution used to flush the IV line should be selected bearing in mind the compatibilities of both medications. For example, some medications are not compatible with D5W, while others are incompatible with normal saline.

The volume of the IV flush administered may vary with the brand and make of tubing used, thus institutions may have different standard flush volumes.

Reference

1. Protocols for comcomitant infusions in the same IV line [Oncology Nurse Advisor Forum]. Oncol Nurse Advisor. 2014 Mar 17. https://www.oncologynurseadvisor.com/home/departments/advisor-forum/protocols-for-concomitant-infusions-in-the-same-iv-line/. Accessed July 7, 2016.