[nightingale]

Our facility does not have a standard of procedure written with flushing ports. Our pt. has a triple lumen subclavian. It has always been my practice to flush with 5cc NS and then 3CC of Heparin flush. Another RN says we can just do the Heparin since we are not using a fluid in between.

Opinions? What does your policy and procedure state?

Thanks in advance.

night

[Mystery5]

Originally Posted by nightngale1998

Our facility does not have a standard of procedure written with flushing ports. Our pt. has a triple lumen subclavian. It has always been my practice to flush with 5cc NS and then 3CC of Heparin flush. Another RN says we can just do the Heparin since we are not using a fluid in between.

Opinions? What does your policy and procedure state?

Thanks in advance.

night

When I worked at a larger hospital where we had a lot of triple lumens, the IV therapy woman told me that it was better to just flush with heparin. She said it was because of infection control and advised to only use saline if there was a med used.

[plumrn]

Our policy is to flush with saline followed by the heparin lock flush solution. I thought it was to be sure all the old Heparin gets flushed through and the catheter is 'flushed' (irrigated?) really well, as well as preventing mixing of other medications.

Maybe this is one of those things that will slowly make the rounds and we will all be skipping the saline (except between medications) in the years to come.

[chad75]

In every facility I have been in we always flushed with just about 5cc of NS or about 3.33 cc's in each one since some nurses get lazy and only want to use 1, 10cc syringe . Part of the logic behind that is we draw labs from the CVC's and most facilitys I have been in don't want you drawing PTT's PT's etc. from CVC's that have recently had heparin infused (although you can waste 10cc's of blood, pull out another 10cc's of blood for your CBC/BMB etc, then pull the blood for the PT/PTT after that and you should be okay, or at least that was the policy in most places I worked...your mileage may vary.

We didn't pull out the heparin until the line was occluded (which 99% of the time is because the last couple of shifts before never flushes the lines).

[schroeders_piano]

In my facility, we flush ports with 10ml of normal saline followed by 100 units of heparin diluted to 5ml. We also must use 10ml syringes because of maintaining certain pressure levels in the lines.

[?burntout]

For CV line maintence, we flush all unused ports with 1 cc of 10 Unit/ml Heparin flush. After giving meds, we flush with 5 cc of NS before and after the med and use 1cc of 10 unit/ml Heparin flush. After lab draws, we flush with 10-20 cc of NS and 1cc of the Heparin flush. That is our current policy (unless it has changed since I've been on leave).

[curleysue]

I have a port and have had a over 2 years. I have it accessed twice a week so I am pretty used to the protocol used here. If a med or infusion is giving the port is first flushed with 10cc NS. Then med is given and then flushed with another 10cc NS and if that is all that is needed with the port it is then flushed with between 5-10cc heparin.

Each week I do have PT drawn. In this case the port is accessed. Flushed hard with 10cc NS then they pull back 10cc blood as the discard. Then place another syringe on for the actually blood drawing. After that it is again flushed with 10cc NS followed by 5-10cc heparin.

Take care. CurleySue

[KarafromPhilly]

In my facility we flush with NS only; frequent heparin flushes have been linked with HITTS (heparin-induced thrombocytopenia with thrombosis syndrome).

[LT Dave]

Originally Posted by KarafromPhilly

In my facility we flush with NS only; frequent heparin flushes have been linked with HITTS (heparin-induced thrombocytopenia with thrombosis syndrome).

I agree, we use just saline no reason to heperinize a pt.

[Mystery5]

Originally Posted by curleysue

I have a port and have had a over 2 years. I have it accessed twice a week so I am pretty used to the protocol used here. If a med or infusion is giving the port is first flushed with 10cc NS. Then med is given and then flushed with another 10cc NS and if that is all that is needed with the port it is then flushed with between 5-10cc heparin.

Each week I do have PT drawn. In this case the port is accessed. Flushed hard with 10cc NS then they pull back 10cc blood as the discard. Then place another syringe on for the actually blood drawing. After that it is again flushed with 10cc NS followed by 5-10cc heparin.

Take care. CurleySue

Do you mind me asking why you have a port???