What is the first step when an occlusion is suspected in the IV line?

• A. Stop infusion and inspect tubing and catheter; check patency; replace as needed.
• B. Continue infusion to see if it clears.
• C. Flush with large-volume saline without assessment.
• D. Remove line immediately without assessment.

Answer: (A)

When an IV line is suspected to be occluded, the top priority is patient safety and preserving access. The first step is to stop the infusion to halt any more fluid or medication from being forced into a blocked line and to prevent potential extravasation or vein irritation.

After stopping the flow, inspect the setup carefully. Look for simple mechanical causes like kinks in the tubing, a closed or clamped line, loose connections, or dislodgement. Also check the catheter site for signs of infiltration or phlebitis.

Next, test patency with a gentle saline flush to see whether the line can be cleared. If the flush passes easily, you may be able to resume the infusion. If there is resistance or no patency, avoid forcing fluid and plan to replace the line or reposition the catheter as needed.

Continuing the infusion to see if it clears or flushing with a large volume without assessment are not appropriate steps, and removing the line without assessment should be avoided because you might lose IV access unnecessarily.