Heplock with no IV running - page 2

I was just wondering what the purpose of keeping a heplock in when no IV fluid is running. Is it just so you don't have to start a new acces in case you need to run fluids?... Read More

  1. by   Daytonite
    Quote from analee23
    we do have problems with clotted off lines once in awhile as we use saline locks as well. this usually occurs with a transfer from another facility (we're a level 1 trauma center). i just unhook the iv tubing or whatever may be attached to the hub, use a blunt tip needle with syringe to pull the clot out and then flush the line. 75% of the time this works and saves the kid from extra trauma. if it doesn't flush easily after pulling a clot out, i never force it, just pull the line and re-stick. analee
    the reason these lines won't flush easily after pulling a clot out are: (1) sometimes when a clot has formed in a cannula, there is already some phlebitis starting to occur in the vein distal to the tip of the cannula because of the clot extending itself. this is traumatic to the inner walls of the vein (think back to thrombophlebitis and its signs and symptoms) and the inflammatory response is set up, so you are having to deal with that. if some swelling is starting to occur (part of the inflammatory response), that is reducing the diameter of the vein making flow through that section of the vein sluggish. (2) wayward cells of blood remain sticking to the cannula and vein walls. one way to deal with this is to flush the now patent saline lock with as much saline as you can using a pumping action (sharp push-stop-sharp push-stop, etc). the pumping action creates turbulence which helps loosen those clinging rbcs and other gunk that hopped on for the ride and helps wash it away into the general circulation. i realize you are working with pediatric patients, but if you can use up to as much as 20ml of saline all the better. however. . .

    these ivs that have this particular problem will go bad, usually with outward symptoms of a phlebitis that you can see with the naked eye within a 24 hour period. can't tell you how many times i saw this as an iv therapist when we saved clotted ivs. still, you want to get as much use out of an existing patent iv site as you can, particularly in peds patients and people who are hard sticks.
  2. by   smk1
    Quote from stevielynn
    Also - does anyone really flush them with heparin anymore? I've never done it, just saline and we call them saline locks.

    steph
    None of our texts refer to them as heplocks, so imagine my confusion when arriving on my first hospital rotation and being asked to put on a heplock. The nurse thought I was an idiot because I told her I was only taught to do saline locks, and don't know how to do a hep lock, and also didn't think I should be running heparin yet! LOL!
  3. by   analee23
    Thanks Daytonite for the tip! I have had veins blow after pulling out a clot like you said. It's usually when the peds floor is full and we're holding them for a few extra hours. But maybe I'll try your technique now and save them for a little longer!

    Again, THANKS, good info and very useful!

    Analee
  4. by   onyx77
    I have used both hep and saline locks in all clinical facilities I have been at. I quess I didn't realize that heplocks were so uncommon. The heparin is used to keep the IV site patent by prevented clot formation in an IV site that is not regularly used. I have only heplocked one peripheral line. We were taught that centeral lines and ports require a heplock if there is no running IV. You need to use the SASH method when administering. (Saline- Administer med- Saline- Heparin) A saline lock and a heparin lock are two different things.
  5. by   moongirl
    We use heparin flush Q 8h if IV not running where I work in OB. they are also hep locked after delivery until they are stable in case of major blood loss and we are running down the hall to the OR.
  6. by   JBudd
    All ours are saline locks with saline flushes q8h, but are sometimes still called hep locks. The only time anyone uses heparin flush solution is for port-a-caths, pic lines or central lines.

    In the ER, if we need bloods (and very few patients don't!), it is just as easy to do it with a hep lock (okay, I'm really old school, lol) to save them another stick if the labs come back abnormal.
  7. by   breeqt
    is there a reason you dont cap off a saline lock? i always thought you should in order to keep it sterile. And yet you do cap off the tubing to an iv med that's running if you disconnect it from the catheter? hopefully my question makes sense.



    Also, i had a pt (5 week old) who had a running iv(i think it was dextrose, some type of f&e) that we stopped so we could flush using the sash method with saline, then gave her her antibiotics then flushed afterwards with saline then heparin. If she already had a running iv what was the point of all the flushes...maybe i'm missing something here. As you guys can tell i'm a newbie to iv's and this is just all sooo confusing.
    Last edit by breeqt on Sep 30, '07
  8. by   MikeyJ
    Speaking of hep-locks... last week I d/c a hep-lock on an elderly patient who was getting discharged from the hospital. I d/c it and put a 4x4 on it and put some tape on it. As the RN and I were going over her discharge papers, we noticed that the entire shirt arm was becoming quickly soaked in blood. Woops! Next time I will put a few 4x4 and apply more pressure with the tape.

    Sorry to hijack the thread.
  9. by   onyx77
    Quote from breeqt
    is there a reason you dont cap off a saline lock? i always thought you should in order to keep it sterile. And yet you do cap off the tubing to an iv med that's running if you disconnect it from the catheter? hopefully my question makes sense.



    Also, i had a pt (5 week old) who had a running iv(i think it was dextrose, some type of f&e) that we stopped so we could flush using the sash method with saline, then gave her her antibiotics then flushed afterwards with saline then heparin. If she already had a running iv what was the point of all the flushes...maybe i'm missing something here. As you guys can tell i'm a newbie to iv's and this is just all sooo confusing.
    All IV lines should have a cap on when there is no continuous IV running. If there is an IV fliud already running (such as with the infant you talked about) you need to flush with NS incase of any medication incompatibilities. Not everything is compatible. Make sense?
  10. by   fmrnicumom
    If you haven't experienced it yet, some kids are really upset by getting an IV or having blood drawn. The last time my son had pneumonia, he lost 5 IVs in the first 24 hours he was admitted. Though he was so sick he did nothing but lie still and sleep, when they had to put in a new IV, it took 4 adults to hold him down to safely get it in. I felt so horrible for him! He was 2 years old. Imagine my concern when they said they needed to do a lumbar puncture!

    I love threads like this because it's an opportunity to learn more. Good stuff!

    Tiffany
  11. by   breeqt
    Quote from onyx77
    All IV lines should have a cap on when there is no continuous IV running. If there is an IV fliud already running (such as with the infant you talked about) you need to flush with NS incase of any medication incompatibilities. Not everything is compatible. Make sense?



    let's say it's a hep lock with nothing running would you cap the port of the catheter? sorry for all the questions and hopefully im making sense
  12. by   Daytonite
    Quote from breeqt
    let's say it's a hep lock with nothing running would you cap the port of the catheter? sorry for all the questions and hopefully im making sense
    A heparin lock IS an IV catheter whose portal is capped off. Any IV device can be converted into a heparin lock or saline lock by removing any IV tubing connected to it all the way to the hub of the IV catheter and then attaching a cap. Then, you merely flush the device with saline to clear whatever solution was previously running through it and then instill heparin or saline into it to "lock" it. "Locking" means instilling a solution into the IV device so that it will remain patent even though it isn't being actively used.
  13. by   IrishIzCPNP
    We call them adapted angiocath

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