Table 2.

Nursing evaluation of access device lacking blood return

Type of device	Intervention
Central VADs	Attempt to flush with normal saline, using gentle pulsatile technique
	Reposition patient
	Ask patient to cough and deep breathe
	Obtain provider order for de-clotting procedure
Midline catheter or peripheral venous catheter	Remove and reinsert
Only after verification of VAD intactness, position, patency, and lack of backflow which is confirmed by imaging study, and only after no other VAD option is available	Obtain provider order for the use of VAD with no blood return

VADs: Venous access device