If an IV line becomes occluded but IV access is still needed, which steps should you take?

• A. Attempt gentle saline flush, reposition needle, check for kinks, and if unsuccessful, replace the catheter or attempt another site.
• B. Immediate removal of IV line with no replacement.
• C. Ignore the occlusion and keep infusing.
• D. Place a new infusion line without addressing the occlusion.

Answer: (A)

When an IV line is occluded but you still need access, the goal is to restore patency with the least invasive steps first and then move to a new access if needed. Start with a gentle saline flush to test and clear the lumen. Use a small amount (about 3–5 mL) and apply a slow, steady push rather than forcing fluid; if there’s no resistance and the line flows, patency is restored. If you encounter resistance, stop to avoid forcing material into the vein and reassess.

Next, adjust the catheter and the limb if needed. Reposition the needle or catheter tip slightly, and look for problems like the tip resting against the vein wall. Check the tubing for external kinks, ensure all connections are secure, clamps are open, and the IV solution bag isn’t collapsed.

If the flush and adjustments don’t restore flow, replace the catheter or attempt another venous site, using sterile technique. This approach preserves IV access whenever possible and avoids leaving the patient without necessary therapy.