Quote from nurs1ng
So to clarify -- is the tip of the arterial line alongside the tip of the balloon? We only get IABP so few times a year. We always place our hep bag in a pressure bag but again I've gotten various responses in that I should manually flush every hour no matter what. One nurse even told me that I should place the balloon pump on stand by prior to manually flushing and reasoning was that "if you manually flush while the balloon is inflating, you're just pushing that heparin back into the coronary arteries." I'm getting confused with different answers here. And I've looked up our policies and procedures and it says nothing about manual flush however all the heart nurses on my unit manually flush (maybe because of how it was done the old way?)
The terms "root line" and "arterial line" are sometimes used synonymously. The very tip of the balloon catheter has a hole in it and that is where the pressure is measured. Patients very often have a standard radial A-line as well, and a blood pressure is measured there too.
Like I said, a pressure bag keeps the catheter lumen patent so routine flushing isn't necessary, but if you did flush it you wouldn't need very much volume at all and the concentration of heparin, I would imagine wouldn't need to be more than 10 units per cc, if that.
The theoretical concern about flushing the coronary arteries is, IMO, misplaced. When a surgeon puts someone on the heart-lung machine, he puts a 20 fr catheter right into the ascending aorta and gives a bolus of 100 cc of crystalloid that doesn't hurt the patient at all.
But if that is what folks do at your place, it's easy enough to pause the pump for a few seconds, flush and then resume normal function.