How should central line patency be confirmed before chemotherapy administration?

• A. Visual inspection of the line for patency
• B. Flushing with saline to ensure flow and assess for infection or occlusion
• C. Administer a saline bolus test and observe response
• D. Rely on patient-reported line comfort

Answer: (B)

Verifying that a central line is open and ready to use means checking the actual lumen function, not just how it looks. The most reliable way to confirm patency before chemotherapy is to flush the catheter with sterile saline and observe the flow. A smooth, unresisting flush indicates the line is patent and able to deliver meds. If you encounter resistance, no return of blood, or signs of swelling or leakage, the line may be occluded, dislodged, or kinked, and it should not be used until assessed further.

As you flush, you also briefly inspect the exit site for signs of infection (redness, warmth, drainage) because infection risk is a separate but important part of line assessment. Relying on visual inspection alone won’t reveal intraluminal occlusions, and a saline bolus without careful observation isn’t as reliable. Patient-reported comfort is not a sufficient measure of patency, since a line can feel fine yet be occluded or improperly positioned.