Central Vascular Access Device (CVAD): Flushing

A CVAD should be flushed as often as your care team tells you, to keep it clear of blood and prevent clotting. If the CVAD has more than one line (lumen), flush them in the same order each time. Depending on the type you have, you will flush it with either heparin or saline solution. Your care team will probably give you supplies and instructions on how to flush it. A nurse may come to your home to help you at first.

You will usually lie down when you flush the line. This helps prevent air from getting into your vein.

Be sure you have all your supplies ready. These may include the heparin or saline solution, syringes, needleless injection cannulas, alcohol pads, clean disposable gloves, and a disposal box. What you need will vary with the type of CVAD you have. You may have syringes that are already filled with the solution (preloaded).

Here are basic tips for how to flush your CVAD.

Preparing the syringe

1. Prepare a clean work area, such as a clean counter in your bathroom. Put your supplies on the clean area.
2. Wash your hands with soap and water for at least 20 seconds. Be sure to wash between your fingers and under your fingernails. Dry your hands with paper towels.
3. Put on the clean disposable gloves.
4. Clean the rubber lid of the heparin or saline solution bottle with an alcohol pad for 15 to 30 seconds.
5. Remove the cover from the syringe, and twist the needle or needleless cannula onto it. (It may already be attached.)
6. Remove the cover from the needle or cannula. Note: If you have a preloaded syringe, skip to the next section, "Flushing the line."
7. Pull back the plunger of the syringe. Draw air into the syringe equal to the amount of heparin or saline solution you are using.
8. Push the needle or cannula through the rubber lid of the solution bottle.
9. Push the plunger of the syringe to force air into the bottle.
10. Turn the bottle and syringe upside down. Position the tip of the needle or cannula so that it is below the surface of fluid in the bottle. Pull back the plunger to fill the syringe with the amount of solution you need.
11. Before you take the needle or cannula out of the bottle, check for air bubbles in the fluid in the syringe. If there are bubbles, gently push the plunger back in to push the air bubbles into the bottle. Then make sure the needle or cannula is below the surface of the fluid in the bottle and then pull back on the plunger again.
12. Remove the needle or cannula from the bottle.
13. Fill other syringes in the same way if you need to flush more than one line. You will use one syringe per line.

Flushing the line

1. Use an alcohol pad to clean the cap of the line you want to flush. Clean for 15 to 30 seconds, and then let the cap dry.
2. Hold the end of the line so it does not touch anything.
3. If you have a clamp on the line, open it.
4. Insert the needle or cannula into the cap.
5. Slowly inject heparin or saline solution. If there is resistance, stop. Do not force it. Contact your care team.
6. If you have a clamp on the line, clamp it as you are finishing the injection and then remove the syringe. If the line has a positive pressure cap, remove the syringe and then clamp the line.
7. Repeat the above steps for each line you are flushing.
8. Put the syringe, needle, or cannula in the disposal box. Dispose of any used materials as instructed.
9. Wash your hands again with soap and water.