What is the pulsatile flush technique in maintaining PICC patency?

• A. Using a push-pause sequence to create turbulent flow
• B. Continuous slow infusion
• C. Flushing with heparin only
• D. Not flushing at all

Answer: (A)

Pulsatile flush maintains PICC patency by actively pushing saline in and out to create turbulent flow inside the catheter. That push-pause sequence generates higher shear forces, which help dislodge forming clots or debris and clear the lumen so the line stays open for use. This is more effective than a continuous slow infusion, which can leave zones of stasis where clots can form. Not flushing at all would almost certainly lead to occlusion, and flushing with heparin alone carries bleeding risks and may not provide additional benefit over the pulsatile saline technique. So the push-pause pulsatile saline flush is the best approach to keep the line patent.