Question about Heparin Drips

[purple_rose_3]

My pt. the other day had a right IJ with heparin running in one port and NS running in the other. I needed to draw an Ionized Calcium. A fellow nurse told me to make sure I stopped both fluids, flush really well and then just draw it off the IJ. Is that what you would have done? Is this the correct procedure?

[meownsmile, BSN, RN]

Yep,, stop both infusions,, flush with NS and wait at least 5 min before drawing the lab.

[Hoozdo, ADN]

My pt. the other day had a right IJ with heparin running in one port and NS running in the other. I needed to draw an Ionized Calcium. A fellow nurse told me to make sure I stopped both fluids, flush really well and then just draw it off the IJ. Is that what you would have done? Is this the correct procedure?

What I would try to do is pause all the fluids, flush the distal lumen, withdraw 10 cc waste from the distal lumen, and then draw blood from distal lumen. Your technique would work, but you would want to draw waste blood so you don't get any heparized blood.

[purple_rose_3]

Sorry, I didn't mention about the wasting, but I definately did that. We had a debate about this at work because some people said you had to draw it peripherally d/t the heparin. They were saying that it wouldn't have been good to stop the heparin to draw these labs.

Meownsmile, why wait five minutes? Just curious?

[meownsmile, BSN, RN]

Its just the protocol we follow. We use the same for flushing a port that has TPN running. Our lab prefers it and i guess it keeps the blood draw from being dilute they think.

[purple_rose_3]

Thank you for responding. I work tonight I think I might see if we have a policy about this!

[Hoozdo, ADN]

Sorry, I didn't mention about the wasting, but I definately did that. We had a debate about this at work because some people said you had to draw it peripherally d/t the heparin. They were saying that it wouldn't have been good to stop the heparin to draw these labs.

Meownsmile, why wait five minutes? Just curious?

Well you are right and they are wrong. What is the harm in pausing the heparin for 45 seconds or a minute? I think it would be cruel and unusual punishment to stick this pt peripherally when he already has a FINE AND WONDERFUL TLC! :roll

[allele, LPN]

Yep, we use ports that have had heparin running all the time. We just need to flush really well and waste, of course. Should be fine! Never had a problem! :)

[miko014]

We aren't supposed to draw a PTT from anything if there is heparin running. Anything else, we can do it just as described above.