When is it appropriate to use a saline flush during dialysis?

Using a saline flush during dialysis is particularly appropriate during treatment if clotting is suspected. This practice can help to maintain patency of the vascular access or the dialysis machine. When clotting occurs, it can impede blood flow, leading to inadequate dialysis and potentially causing complications. Administering a saline flush can help dislodge or dissolve small clots that may form, improving the function of the access site and ensuring that the dialysis process continues effectively.

In other contexts, such as before or after treatment, saline flushes are generally not indicated specifically for clotting issues. A saline flush before initiating treatment is typically not necessary as the access site should be patent from prior usage. After treatment, assessing residual volume is generally done without the need for a flush, focusing instead on post-dialysis evaluation and care. The suggestion that it's never appropriate disregards clinical scenarios where a saline flush can be beneficial in maintaining a clear pathway for blood flow during dialysis due to clotting concerns.