Catheter flushing involves injecting a sterile fluid into the catheter tube to actively clear the internal lumen of the device. The primary goal is to maintain patency, which means preventing blockages from forming within the narrow tubing. This action dislodges and washes away potential obstructions such as mineral sediment, mucus, or small blood clots that accumulate over time. Regularly flushing the catheter significantly reduces the risk of urinary stasis or the buildup of foreign material that can increase the likelihood of a localized infection.
Gathering Your Materials and Preliminary Steps
Before beginning the procedure, it is important to gather all necessary items in one clean, accessible location. These supplies typically include a pre-filled, sterile syringe containing the flushing solution, usually 0.9% sterile sodium chloride (saline) or sterile water, along with antiseptic wipes, a pair of clean, disposable gloves, and an appropriate waste receptacle. The syringe volume used is generally between 10 and 30 milliliters, which provides enough solution for an effective flush without over-pressurizing the system.
Hands should be washed with soap and water for at least 20 seconds or cleaned with an alcohol-based hand sanitizer before opening the sterile packages. The patient should be positioned comfortably, ensuring the catheter access port or injection site is easily visible and accessible. The sterile syringe should be prepared by removing the protective cap and expelling any small air bubbles by gently pushing on the plunger before it is connected to the catheter.
The Step-by-Step Manual Flushing Procedure
The manual flushing procedure begins by donning the clean, disposable gloves to establish a barrier against potential contaminants. The injection port or access point on the catheter tube must be meticulously cleaned using an antiseptic wipe, typically by scrubbing the hub in a twisting motion for at least 15 seconds. After cleaning, the port is allowed to air dry completely before the syringe is attached.
The pre-filled syringe is then connected firmly to the catheter port. If the catheter is connected to a drainage bag, the tubing is clamped just below the injection port before the solution is introduced. Clamping prevents the flushing solution from flowing immediately down into the drainage bag and instead directs it into the catheter and toward the bladder.
The sterile solution is then gently injected into the catheter lumen using slow, steady pressure on the syringe plunger. Experts often recommend a subtle “push-pause” or pulsatile technique, which creates turbulence within the tube to help dislodge stubborn debris or sediment. Inject the full prescribed volume of solution, typically between 5 and 10 milliliters for a standard flush, to ensure the tubing is adequately rinsed. The pressure must remain consistently low to avoid damaging the delicate lining of the bladder wall or the catheter balloon.
Once the solution has been fully injected, the syringe is disconnected from the port, and the clamp on the drainage tubing is immediately released. For urinary catheters, the sterile solution is expected to flow back out into the drainage bag, often carrying the cleared debris with it. If the procedure is for a central line or other non-urinary catheter, the solution may need to be carefully aspirated back into a new syringe, depending on the specific protocol.
Recognizing and Addressing Catheter Complications
If a strong, unyielding resistance is met when gently pushing the plunger, the procedure must be stopped immediately. Forcing the fluid against a complete blockage can cause trauma to the catheter or surrounding tissue. The patient may also report sudden, severe pain or cramping in the lower abdomen or around the catheter insertion site, which signals the need to cease the flush.
Other signs of complication suggest a developing issue. If any of these adverse signs occur, halt the procedure and contact a healthcare professional immediately for further evaluation:
- Leakage of fluid around the catheter insertion site.
- A sudden, unexplained decrease in urine or fluid output following the procedure.
- Systemic signs, such as the onset of a fever, chills, or a general feeling of malaise, can suggest a developing infection.
- Any new appearance of cloudy, foul-smelling, or bloody drainage that persists after the flush is also a cause for concern.