Hello, I am wondering if any nurseries/units are using TKO rates instead of saline lock? If so, what is your TKO rate for newborns? I appreciate any thoughts of TKO vs. Saline Lock for longevity of IV sites in newborns. Thanks!

If it's a PIV we generally heparin lock them. Lately we had a big baby who had difficult IV access and needed 10 days of antibiotics. Our neonatologist placed a PICC line and we ran UAC fluids (1/2 normal saline with 1 unit Heparin/mL) at 0.4 mL/hr until the antibiotics were finished being given then the PICC was discontinued. I have noticed over the years that heparin locks don't seem to last nearly as long as PIVs that have a little fluid running though them. I wonder if the fluid dilutes the medications and helps cause less irritation to the vein from the medications or maybe the fluid running helps in some other way. Wish I knew the answer. By the way, we heparin lock our PIVs and flush every 3-4 hours with a 2 unit/ml heparin solution prefilled syringe from our pharmacy.

We saline lock our PIV's, our piccs and 2nd lumen of our uvc's we run hep saline thru at 0.5ml/hr. We quit using heparin on our PIV's about 6 or 7 years ago since EBP showed no difference in the longevity of the line.

Saline lock PIV's with every cares. PICCS vary from D5, D10, 1/2NS and NS with 1u/ml heparin depending on the baby, little ones we run it at 0.5ml/hr, bigger ones we run @ 1ml/hr. We hep lock broviacs q12 hrs

We saline lock our PIVs and flush them with NSS every 6 hours.

For PICCs, we pull them when we are infusing into the primary lumen