central line flushing do you aspirate?

Nurses General Nursing

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Hi there everyone! Sorry if I'm asking a retarded question - haven't had any experience dealing with central lines before... My pt has a left central line triple lumen... Our hospital policy is Flush with 5cc NS and follow with 3cc heparin lock flush.. I've just been reading up and text says to aspirate before flushing... Is that common practice? And how often do you change dressings? Our hospital is 48-72 hours prn.. Do you use transparent or gauze? Thank you!

Specializes in Med-Surg.

And remember to use a 10ml syringe or larger when flushing central lines even when the volume of your solution is less than 10 ml. The narrow lumen syringes exert too much pressure and can damage the central line caths.

thx everyone!

Specializes in Step down, ICU, ER, PACU, Amb. Surg.

persOnalityRN,

I wish I could find the inservice that I developed on central lines for my last facility. Incorporating the facility's protocols with ose of the CDC, it was used as a hospital wide training aid to familiarize everyone with how to care for, change the dressing and flush a variety of cental lines. If you are interested at all, I would be happy to try and locate it for you. The US CDC was still recommending a 72 hr dressing change for them as of last yr. Syringes should never be larger than 10cc to prevent collapse as well as damage to the blood (especially if drawing labs). If returning the blood aspirated, make sure that aseptic techniqu is strictly observed as this is a direct pathway into the main blood stream and could cause a whopper of a sepsis and always flush as per your facility's protocol with the appropriate solution of heparanized saline. Some lines only require heparainzation monthly if being flushed daily with saline. Hope that this helps.

hello~

My institution seems to have rather different protocol from most of you.

Aspirating for back flow is strictly done to check patency only. We're not allowed to aspirate when flushing for fear of leaving blood clot remnents along the catheter. We flush with 10mls of N/S followed by 50 units (5 mls)of heparin saline. Lines that are not in use are flushed once a week.

tip: Nurse clinicians here taught us to clamp the catheter just when 4.5 mls of heparin saline is flushed in, leaving the remaining 0.5 mls in the syringe to maintain a positive pressure. (prevent a backflow of blood along catheter)

Dressing is done once a week using this special catheter dressing, the IV3000. It is clear and transparent, very much like a tegaderm. It is moisture responsive and the material are more skin-friendly. It is more permeable to water vapour than other films.

More info: www.iv3000.com

We use primapore+tegaderm dressing for patients who are sensitive to IV3000. Primapore dressings are changed twice a week.

Hope this is helpful~ take care

Specializes in Med-Surg/Tele, ER.

You got some great responses on the flush question, so I won't go there. I just wanted to ask you to not use the word "retarded" to indicate dumb, it is hurtful and (at best) highly unprofessional.

Just a pet peeve of mine. Thanks. :)

Specializes in Hem/Onc.

I'm a HEM/ONC nurse. We change dressings qWk. Transparent only. If you must use gauze for a bleed, you must then change the dressing qDay. Leaving gauze under the dressing for more than one day is an infection risk.

We always aspirate and discard 3cc of blood, as it contains the heparin we locked the lumen or port with previously. I teach our nurses that we are "withdrawing the heparin", because evidence is inconclusive about how much heparin can cause a DIC response in patients.

That's our protocol. Check out your institution's.

Good luck.

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