Saline flush

Nonpharmacologic management of thrombosis in a hemodialysis catheter involves saline flushes. Smaller clots may be managed by balloon angioplasty to mechanically open the catheter. In severe cases in whom clots cannot be removed by either mechanical or pharmacologic therapy, the catheter may require replacement. 

IV infusion 3-5 U/h (50 U in 250 mL of normal saline flush IV tubing with 20 mL of soln before starting infusion). 

Sermorelin may be used as a diagnostic test for pituitary GH reserve according to the following protocol After an overnight fast, the patient has blood drawn for GH at -15 and 0 minutes sermorelin 1 g/kg is injected intravenously, followed by a 3 mL normal saline flush of the infusion line. Blood for GH is then drawn at 15, 30, 45, and 60 minutes following the injection. Serum GH levels must reach a peak of over 2 ng/mL to be considered a positive response. 

Edrophonium is available in multiple-dose or singledose 10-mg/ml ampules. An accessible vein is foimd on one of the patient s arms, and a butterfly infusion set with a 27-gauge needle is attached to a 1-ml tuberculin syringe containing 10 mg edrophonium solution. Initially, 2 mg (0.2 ml) edrophonium is injected intravenously. A saline flush may follow this injection to confirm appropriate dose administration. If after 1 or 2 minutes definite improvement in ptosis or ocular misalignment occurs, the test is considered positive and no further edrophonium injection is necessary. If no definite improvement occurs, however, another 3 mg (0.3 ml) edrophonium is injected and the patient is again observed. 

If an i.v. line cannot be placed, the intraosseous drug administration route can be used for pediatric patients during, for example, cardiopulmonary resuscitation (CPR) because drug delivery by this route is similar to that for i.v. administration.If drug or fluid deliver by this route is sluggish, a saline flush can be used to clear the needle. Intraosseous administration is used to deliver medications such as epinephrine, atropine, sodium bicarbonate, dopamine, diazepam, isoproterenol, phenytoin, phenobarbital, dexametha-sone, and various antibiotics. ... 

If a catheter-related thrombus is suspected, a series of saline flushes can be used to try to clear the catheter. Although this would indicate the thrombi has embolized, it is considered safe and frequently effective. Intraluminal thrombolytics are a second option and are widely used in dialysis units. The thrombolytic with the most ex-... 

Forced saline flush Mechanical thrombectomy Catheter stripping... 

Schoellnast H et al (2003) Abdominal multidetector row computed tomography reduction of cost and contrast material dose using saline flush. J Comput Assist Tomogr 27(6) 847. 

Haage P et al (2000) Reduction of contrast material dose and artifacts by a saline flush using a double power injector in helical CT of the thorax. AJR Am J Roentgenol 174(4) 1049. 

Normal saline flush would help cleanse the bleach from the eyes, but it is not the first intervention. 

Be comfortable with a number of trouble shooting/salvage techniques in case of compli-cations/malfunction. For example, snaring or forceps retrieval a misplaced coil, deployment of a coil stuck in a catheter with a saline flush using a TB syringe [108]. 

Tarazov PG, Gapchenko EM, Dmitrieva lA, Ryzhkov VK (1992) Coil embolization using a saline flush technique [comment], Br J Radiol 65 1055-1056... 

The author has used percutaneous CT guided thrombin injection in six patients where pancreatitis associated aneurysms could not be seen at selective angiography. The technique is relatively simple, the aneurysm being punctured with a 21-Gauge saline flushed needle under CT guidance... 

This technique is suitable for all fibered pushable microcoils (0.018-in.) through microcatheters. The microcoil is loaded into the microcatheter and a 1-ml luer lock syringe with saline flush is attached to the hub of the microcatheter. Under fluoroscopic guidance the microcoil is delivered with small boluses of flush. Final adjustment of the microcoil can be done by moving the microcatheter before final delivery of the complete coil, if the initial deployment of the coil is distal to the site for deployment. 

Schoellnast H, Tillich M, Deutschmann HA, Stessel U, Deutschmann MJ, Schaffler GJ, Schoellnast R, Uggowit-zer MM (2004a) Improvement of parenchymal and vascular enhancement using saline flush and power injection for multiple-detector-row abdominal CT. Eur Radiol 14 659-664... 

Fig. 9.1. a An 11-year-old girl with an osteoid osteoma of the left pedicle of the sixth vertebra of the thoracic spine. Note the partially sclerosed nidus together with the dense surrounding hyperostosis, b The dense cortical lamella was perforated by a biopsy cannula with a crown cut. c Subsequently, a radiofrequency single electrode with an active tip of 1 cm was placed into the nidus. To protect adjacent myelin structures a 21-gauge needle was placed into the epidural space for saline flushing... 

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