Flushing Ports

[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

[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

[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).

[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]

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.

[LT Dave]

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]

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???

[Mystery5]

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???

[Hellllllo Nurse, BSN, RN]

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

Agree. I was taught to flush lines with NS only. Between uses, lines are packed with 5000u/ml heparin, but not flushed with any heparin- this would cause the pt to be systemically heparinized.

The amount of the pack is 0.1cc over what the pack volume of the line is. For example: If the Art and Venous line pack volumes of a Split Ash are 2.0 and 2.1cc, you would pack with 2.1 and 2.2 cc (respectively) of 5000u/ml heparin. With pts whose lines clot frequently, you can get an order to pack with Activase (you must put special labels on the lines stating that they are packed with Activase -DO NOT FLUSH) if your facility allows it.

[Hellllllo Nurse, BSN, RN]

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

Agree. I was taught to flush lines with NS only. Between uses, lines are packed with 5000u/ml heparin, but not flushed with any heparin- this would cause the pt to be systemically heparinized.

The amount of the pack is 0.1cc over what the pack volume of the line is. For example: If the Art and Venous line pack volumes of a Split Ash are 2.0 and 2.1cc, you would pack with 2.1 and 2.2 cc (respectively) of 5000u/ml heparin. With pts whose lines clot frequently, you can get an order to pack with Activase (you must put special labels on the lines stating that they are packed with Activase -DO NOT FLUSH) if your facility allows it.

[Thunderwolf, MSN, RN]

This can be a little confusing folks, since not all ports are alike. Are you talking about a triple lumen, a broviac, a PICC, a midline catheter, an IVAD...you get my drift. Some require 2cc or 3cc or 5cc of heparin to maintain patency as a post flush. It depends on the device. PICCs definately require a 10cc syringe due to higher pressures exerted by smaller syringes...not good for PICCs (could rupture them). And there is a newer type of PICC that due to a new valve only is flushed with NS...no heparin at all. Use the SASH method with any of them, however, when giving meds (except these newer PICCs that I just mentioned). In the hospital, we flush q 8 hrs when not used. You really need to look at your facilities protocols for each. For these devices, there are usually protocols.

[Thunderwolf, MSN, RN]

This can be a little confusing folks, since not all ports are alike. Are you talking about a triple lumen, a broviac, a PICC, a midline catheter, an IVAD...you get my drift. Some require 2cc or 3cc or 5cc of heparin to maintain patency as a post flush. It depends on the device. PICCs definately require a 10cc syringe due to higher pressures exerted by smaller syringes...not good for PICCs (could rupture them). And there is a newer type of PICC that due to a new valve only is flushed with NS...no heparin at all. Use the SASH method with any of them, however, when giving meds (except these newer PICCs that I just mentioned). In the hospital, we flush q 8 hrs when not used. You really need to look at your facilities protocols for each. For these devices, there are usually protocols.