Registered Nurses' Association of Ontario

The Four Elements of Locking and Flushing

  • Flushing and locking interventions involve four elements that need to be described in client specific orders and/or in established medical directives.
  • These four elements include:
    • Type of solution
    • Concentration of solution
    • Volume of solution
    • Frequency of administration
  • Organizations may choose to modify the chart below based on current clinical practice, device technology, and/or patient assessment:

 

Vascular Access Device

Flushing Solution

Lock Solution

Frequency

Peripheral Short-Catheter

Flush and lock with 3 mL 0.9% sodium chloride

After each access or

daily if not in use

Peripheral Midline-Catheter

(non-valved)

5 – 10 mL

0.9% sodium chloride

Heparin (commonly used

concentrations are 10 or 100 units/mL)

After each access or

weekly if not in use

Peripheral Midline-Catheter

(valved technology)

Flush and lock with 10 – 20 mL 0.9% sodium chloride

After each access or

weekly if not in use

Central Vascular Access Device

(CVAD), non-valved (e.g. Percutaneous,

Tunneled, PICC)

10 – 20 mL

0.9% sodium chloride

Heparin (commonly used concentrations

are 10 or 100 units/mL)

After each access or

weekly if not in use

CVAD with valved technology

(e.g., Groshong®, PASV®)

Flush and lock with 10 – 20 mL 0.9% sodium chloride

After each access or

weekly if not in use

Implanted Vascular Access Devices

(IVAD), non-valved

10 – 20 mL

0.9% sodium chloride

Heparin (commonly used concentrations

are 10 or 100 units/mL)

After each access or

every four weeks if

not in use

IVAD with valved technology

(e.g. Groshong®, PASV®)

10 – 20 mL

0.9% sodium chloride

As per manufacturers’ recommendations

As per manufacturers’

recommendations

Clinical Management
Care and Maintenance to Reduce Vascular Access Complications
Sample Tools