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How to Flush a Peripheral IV (PIV)

What is a peripheral IV?

A peripheral intravenous line or catheter is a small, short tube placed into a vein through the skin using a needle. A peripheral IV is a way to take blood samples or give some medicines or fluids into a vein. Most of the time it is placed in the:

  • Hand
  • Arm
  • Foot
  • Scalp (in babies)

You might hear a peripheral IV called a PIV, peripheral intravenous line, or peripheral intravenous catheter.

Find more information on how a peripheral IV is placed.

Peripheral IV in child's arm

A peripheral IV or PIV is a way of giving medicine or fluid into a vein.

A PIV usually has a clear bandage over it where it goes into the skin. This keeps air and water from getting in but allows caregivers to see the site when they are giving medicine. At the end of the tube is a plastic clear connector. It connects to the medicine, fluid, or IV pump. You will also see a clamp on the tube.

If the PIV is in your child’s hand, an arm board may be used to help keep the PIV in the right place. An arm board will limit how much your child can move their hand. Tell your care team if your child has numbness, tingling, or skin color changes in the hand where the PIV or arm board are located.

How to do a saline flush in the peripheral IV

A saline flush helps keeps the peripheral IV from sealing off and not working. Flush the PIV every 8 to 12 hours or as instructed by your care team. You can usually flush it right before bedtime. This means you won’t have to wake your child up during the night.

If you have questions about how or when to flush the IV, talk with your care team.

Do not flush the PIV unless you have been told to do so and have received training.

Supplies needed:

  • 2 Site-Scrubs® or alcohol prep pads
  • 1 syringe of sterile sodium chloride (saline for IV use). Check the label for:
    • 0.9% sodium chloride injection on the syringe
    • 5 milliliters (mLs) of liquid in the syringe
    •  An expiration date on the syringe - if expired, do not use.
  • 1 disinfectant cap

  1. 1. Clean your work area and gather supplies

    • Clean your work area with an alcohol prep pad or other disinfectant.
    • Wash your hands with soap and water or use an alcohol-based hand sanitizer.
    • Dry your hands well or allow them to air dry if you use hand sanitizer.
    • Gather your supplies and place them in your clean work area.

  2. 2. Prepare the saline syringe

    • Remove the cap from the saline syringe. Do not touch the inside of the cap or the tip of the syringe.
    • Set the cap down so the inside is facing up.
    • Hold the syringe upright, and pull back on the plunger of the syringe.
    • Look for any large air pockets, and tap out the bubbles.
    • Slowly push the air out of the syringe and stop when the top of the plunger is at the 1.5 mL mark. You will only give 1.5 mL of the saline as you flush the syringe.
    • Place the cap back on the syringe. Be careful not to touch the inside of the cap or the tip of the syringe.
    • Lay the saline syringe down on the table. It is ready to use.

  3. 3. Clean the clear connector

    • Open 2 Site-Scrubs® or alcohol pads. Place them on the clean work area.
    • Take the disinfectant cap off the clear connector and put it aside.
    • Clean the clear connector.
      • If using the Site-Scrub®, scrub with a back-and-forth motion for 10 seconds. Let dry for 5 seconds.
      • If using an alcohol pad, wipe the end of the clear connector for 8 seconds on the top and for 8 seconds around the rim. Let dry for 15 seconds.
    • Do not blow on or fan the clear connector.
    • Do not lay the clear connector down after it is clean.

  4. 4. Flush the line with saline

    • With your free hand, pick up the saline syringe and remove the cap without laying down the clear connector.
    • Attach the saline syringe to the clear connector.
    • Unclamp the sliding clamp on the IV tube.
    • Slowly push the saline into the tube with a pulsing motion.
    • As you push the last bit of saline into the line, close the clamp.
    • Unscrew the syringe from the clear connector.

  5. 5. Clean the clear connector again

    • If using the Site-Scrub®, scrub with a back-and-forth motion for 10 seconds. Let it dry for 5 seconds.
    • If using an alcohol pad, wipe the end of the clear connector for 8 seconds on the top and for 8 seconds around the rim. Let dry for 15 seconds.
    • Do not blow on or fan the clear connector.
    • Do not lay the clear connector down after it is clean.

  6. 6. Cap the line

    • Put the new disinfectant cap over the clear connector.
    • Throw away the old cap and other used supplies in the regular trash.
    • Clean your hands again.

When to call your doctor

Call the clinic or hospital if you notice any of these problems:

  • Trouble flushing the PIV
  • Pain or tenderness around the PIV
  • Fluid leaking around the PIV
  • Swelling or redness around the PIV or above it
  • Loose, wet, or dirty bandage
  • PIV comes out
  • Numbness or tingling in the hand where the PIV is located

If you have any of the problems above while you are flushing the PIV, clamp the IV tubing, take the syringe off, and put a disinfectant cap over the clear connector.

If the PIV comes out, press on the area with sterile gauze until the bleeding stops. Then, put on a self-stick bandage such as a Band-Aid®.

If the bleeding does not stop after 5 to 10 minutes of pressing on the area, contact your clinic right away. After hours or on the weekend, call the hospital and ask for the nursing coordinator or the doctor on call.

Reminders

  • Follow all steps as instructed to keep the PIV clean and prevent infection.
  • Flush the PIV every 8 to 12 hours or as instructed by your care team.
  • You can usually flush the PIV right before bedtime.
  • If you notice problems with the PIV or your child has numbness, tingling, or redness near the PIV, let the care team know.
  •  Follow the care team’s instructions for when and how to flush your child’s PIV.

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Reviewed: August 2022