Cordis/Introducers

  1. 0 Was looking for practice issues in other areas regarding the "locking off" of the cordis/introducer. I work in a post surgical unit and we use them for our open heart patients. We have a lot of varying information regarding locking those catheters before we have an order to discontinue. Any thoughts out there?
  2. Visit  kc4nrsng profile page

    About kc4nrsng

    Joined Apr '11; Posts: 4.

    10 Comments so far...

  3. Visit  sunnycalifRN profile page
    2
    "Locking off" the cordis? Please explain. In my unit, PA cath is DC'd and the cordis is left for our use until we transfer the patient to the stepdown unit. We usually DC the cordis prior to transfer.
    Last edit by sunnycalifRN on Apr 15, '11 : Reason: clarification
    Rabid Response and CCL RN like this.
  4. Visit  kc4nrsng profile page
    0
    We do that as well. However before they transfer do you stop running fluid through it?
  5. Visit  MunoRN profile page
    0
    It's not often that an open heart doesn't have something running, but on the tele floor I used to work on, all of our hearts still had their cordis in place and usually without any fluids running continuously. (AACN recommends introducers only remain in for patients with a 1:2 ratio and we were 1:6 but that's a different issue). We would just saline lock them, I've never seen one occlude although by day 4 or 5 they usually don't draw any more.
  6. Visit  sunnycalifRN profile page
    0
    Quote from kc4nrsng
    We do that as well. However before they transfer do you stop running fluid through it?
    I understand what you mean. Before we can DC the cordis, we have to have two good peripheral IV's. So, usually, any drips have been switched to the peripheral IV's or a PICC. If we're still running a pressor that shouldn't run peripheral, we can't DC the cordis. But, if we're running a pressor, we won't transfer the patient anyway.
  7. Visit  Biffbradford profile page
    0
    Like a heparin lock? or capping with sodium citrate? Is that what you're after?
  8. Visit  kc4nrsng profile page
    0
    Yes like a heparin lock w/o the heparin. For example; on post op day one morning we will stop running fluids and saline lock the cordis to take the patient for a walk and then not restart any fluids as most of the time they will transfer to tele once the surgeon or the PA has rounded and written orders. Sometimes the patient might not be able to transfer for one reason or another but they don't need fluid running; in those situations we have been under the impression that they shouldn't be left saline locked. We have an order post operatively to TKO fluids when patient is taking po fluids well. Usually they can't get enough; but we only run the fluid at 30ml/hr anyway. It seems like there is no evidence-base practice out there.?
  9. Visit  TakeBack profile page
    0
    Quote from kc4nrsng
    Yes like a heparin lock w/o the heparin. For example; on post op day one morning we will stop running fluids and saline lock the cordis to take the patient for a walk and then not restart any fluids as most of the time they will transfer to tele once the surgeon or the PA has rounded and written orders. Sometimes the patient might not be able to transfer for one reason or another but they don't need fluid running; in those situations we have been under the impression that they shouldn't be left saline locked. We have an order post operatively to TKO fluids when patient is taking po fluids well. Usually they can't get enough; but we only run the fluid at 30ml/hr anyway. It seems like there is no evidence-base practice out there.?
    If they are taking PO, have a PIV, and don't have infusions running then just take the line out.
  10. Visit  kc4nrsng profile page
    0
    Amen.. we are trying to get out surgeons to add to post op orders
  11. Visit  JF808Rn profile page
    0
    saline lock should do it w/ a flush @ every shift change. at least that's SOP at my facility.
  12. Visit  CABG patch kid profile page
    0
    I'm not sure if your concern is stemming from the cordis clotting off or it being a source of infection, but either way, we have had several patients who still have their cordis, saline locked, with no current IVF running. Reason being, in our order set we can leave the cordis in until Vancomycin is d/c'd (48hr post op) and for KCL infusions. Often times, the pt is not getting a maintenance fluid because our docs worry about fluid overload in our post op valve pts. Sometimes we leave until we get a PICC or the doc will order to d/c it post op day 1. It all depends on the pt. We do strive to get central lines out asap to prevent central line associated blood stream infections.


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