Heplock with no IV running

  1. 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?
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  2. 25 Comments

  3. by   Spidey's mom
    Quote from BillboSN
    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?
    Or IV pain meds or IV antibiotics or antiemetics.

    When there is no need for IV access, docs d/c them.

    steph
  4. by   cardiacRN2006
    Yes, or in case I need to give a med IVP or some meds IVPB.
  5. by   Spidey's mom
    Also - does anyone really flush them with heparin anymore? I've never done it, just saline and we call them saline locks.

    steph
  6. by   BillboSN
    I am in my peds rotation and the policy at the hospital is 10cc hep flush. I have also heard them called both heplocks and saline locks.
    Last edit by BillboSN on Sep 25, '07 : Reason: error
  7. by   Spidey's mom
    Quote from BillboSN
    I am in my peds rotation and the policy at the hospital is 10cc hep flush. I have also heard them called both heplocks and saline locks.
    Interesting . . .I love how everyone's practice differs.

    steph
  8. by   santhony44
    They are also called "intermittent access devices" in some places.
  9. by   MikeyJ
    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
    No one has really sat us down in nursing school and explained hep-locks, but I always thought they were called "heplocks" because with a port going into the body without a continuous IV fluid flowing, the blood is going to soon or later clot at the site of the hep-lock and thus they use heparin to "unlock" it. I have no idea if that is right or not, but it made sense to me! haha..

    But most of the nurses use saline to flush it... so that kind of contradicts my thoughts on the heplock.
  10. by   Daytonite
    The purpose of a saline or heparin lock is to maintain a patent venous access. The advantage is that the patient doesn't need to be continually stuck when IV access is needed. That's all. As with all IV devices, standards of care must be followed. An IV device should never dwell in place for longer than 72 hours whether it is being used or not.

    Originally, they were referred to as Heparin wells and the IV's were "locked" or closed with solutions of Heparin to prevent the IV cannulas or needles from becoming clotted off with blood. Otherwise, a venous access was maintained by keeping IV fluids infusing at a keep open rate. Heparin wells started to become popular in patients with congestive heart failure and renal failure whose IV fluids had to be restricted. Eventually, they began calling these heparin locks rather than heparin wells. They began to become more popular, practical and time saving for the nurses compared to a dripping IV bag at a keep vein open rate. Then, it was discovered that the patency of these heparin locked devices could still be maintained using nothing but saline if they were flushed in a correct manner. It's also cheaper. That caught on rapidly. Today it is very common to see saline locks. Back when I started nursing in the early 1970s it was not as common to see heparin wells or heparin locks on the general nursing units unless a patient had transferred from the ICU/CCU with one.

    Some hospitals will still have heparin flushing as part of their policy, particularly in pediatric patients. The reason is probably to avoid having to restart the IV due to clotting off. Starting IVs in kids is traumatic for them. If you've never worked in peds or on an IV team that started IVs in kids you have no idea how difficult it can be for both the kid and the nurse, not to mention the parents standing by having to observe all this!
  11. by   jmgrn65
    If the patient is on tele, at least in our facility, it is policy to have iv access to be able to treat arrythmias if needed.
    ours are saline locks.
  12. by   Spidey's mom
    Quote from jmgrn65
    If the patient is on tele, at least in our facility, it is policy to have iv access to be able to treat arrythmias if needed.
    ours are saline locks.
    This can be policy too in obstetrics . . .although in my small hospital, we didn't do this on a regular basis.

    Of course I'm torn - it is nice not to have to stick someone in labor but if something goes wrong, it is nice to have a saline lock in them.

    Daytonite - great post!

    steph
  13. by   analee23
    I work in a pediatric ED and it is common practice to place saline locks. The rationale is, if the doc wants blood work... why not put an IV in to save the child from more trauma?? If the vein blows and we're able to get all of the blood work, we often will wait to see before sticking the kid again. It's kinda nice to be able to draw blood, wait for results... results show possible bacteremia and being able to administer an IV antibiotic without having to stick a kid again!

    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. Having the parents watch you carefully try and pull a clot out always helps them realize that you're doing everything you can to save their child from extra trauma as well.

    Hope this helps!

    Analee
  14. by   suzy253
    Quote from jmgrn65
    If the patient is on tele, at least in our facility, it is policy to have iv access to be able to treat arrythmias if needed.
    ours are saline locks.
    Same here. I work tele and if they're hooked up to the heart monitor they must have a working IV access.

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