Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Flushing and Locking Interventions Table

Organizations may choose to modify Appendix C based on current clinical practice, device technology, and/or patient assessment. Ensure that the catheter lumen is flushed using Sodium Chloride 0.9% prior to locking the lumen.

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

Note: Heparin is absolutely contraindicated in patients with Heparin-induced Thrombocytopenia (HIT), consult with physician re: alternative measures. For more details about flushing and locking solutions, please refer to the manufacturer’s recommendations.