Help with Hep-lock!
- 0Hi, new grad here with new job in LTC. Needless to say, I had a crappy clinical education in school. I am getting oriented on IV therapies next week and want to get as many dumb questions out of my system before then!
Can you explain exactly what a Hep-Lock is? (yes I googled it but i want to hear it from nurses!)
Additional questions - -
1) Why would someone get a Hep Lock?
2) Are they inserted in the same sites as "normal" IVs? i.e. hand, forearm, etc.
3) What is the procedure when dealing with a hep-lock?
4) Does it look different - - - how will I know if a res has a heplock?
5) Can everything go thru a heplock? i.e. abx ivs, replacement fluids, etc?
THANK YOU IN ADVANCE TO ALL WHO TAKE THE TIME TO RESPOND!
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- 1Mar 1, '11 by April, RNYou started the last thread on heplocks.
A heplock is just another name for a "regular" IV. Anything can run through a peripheral IV (aka heplock) as long as it doesn't require a central line like IV potassium. Some still call it a heplock because in the past, they used to flush with heparin to keep the IV from clotting off. We don't do this anymore - we just use saline to flush. You might also hear it called a saline lock.
- 0Quote from April, RNOh my gosh - - - I'm dying over here! Soooo sorry. I've been a little stressed lately at work....did not remember that I posted it already!!! THANK YOU.You started the last thread on heplocks.
- 1Mar 1, '11 by April, RNDon't stress! IVs aren't that big of a deal. They just seem like it right now because you aren't familiar with them! I'm sure it will make more sense when you get your IV therapy training. Don't be afraid to ask questions! And of course, you can always come here to ask more questions.
- 0Mar 1, '11 by classicdame GuideSome people refer to it as a saline lock. In other words, the IV catheter is in place and the patient may get boluses or continuous fluids depending on need.
BTW, the Infusion Nurses Society is discouraging the use of Heparin (where it got it's name) for flushing saline locks. Normal saline is preferred. There has been a lot written lately about HIT (Heparin Induced Thrombocytopenia) so most facilities now use saline. We like to keep calling things by old names, though, like "Kleenex" for every facial tissue there is
- 3Mar 1, '11 by noahsmama"Hep-lock" and "saline-lock" are not devices, they are procedures, used to flush venous access devices, which include peripheral IVs, PICCs, and other types of central lines (Broviacs, etc.).
I've only worked peds. I gather with adults, people sometimes say "hep-lock" when they mean "saline lock". In peds we never did that, because there were some venous access devices that were always saline locked, and others that were always hep locked.
PIVs were always saline locked. This was done q 8 hours if the line was not infusing. The purpose is to keep the line patent when not being used, so that it will be available for use if/when you need it. Saying that a PIV was "saline locked" was another way of saying that it was not currently being used. At change of shift report, in addition to telling the oncoming nurse where the pt had PIVs, I would always tell them if it was infusing or not, and if not, at what time it was last saline locked. We worked 8 hours shifts, so PIVs would need to be flushed (i.e. saline locked) once a shift.
PICC lines in peds (at least the peds hospital where I used to work) are always hep-locked when not infusing. This is either done q12 hrs (for bigger pts with larger PICCs) or q 8 hrs (for littler pts). The procedure was to flush each lumen on the PICC with 3 ml of normal saline first, then 2 ml of a dilute heparin solution. The idea is that this small amount of heparin will prevent clots from blocking off the PICC, so again the purpose was to maintain patency of a venous access device not currently in use. And again, the last time the device was hep locked would be reported to the oncoming nurse.
I'm pretty sure that Broviacs were also hep-locked, but not certain, since I rarely worked with pts that had those (more common in oncology, which is not the type of unit I worked on).
The exact procedures for each type of device (mls of NS, mls of heparin, and frequency, i.e. q 8 or 12) was posted in our med room.
I hope that clears it up for you -- good luck with your new job!
- 0Mar 1, '11 by boatWhen I was learning, it was helpful to watch some of the youtube videos. There are plenty if you type in
how to convert iv to saline lock.
All you are doing is disconnecting the long tubing and connecting the catheter left in the patient to a short version (small u shaped tubing) taped to the pt's hand (or elsewhere).
There is still access to give meds through the lock and you can quickly hook up tubing again if a bag of something is ordered. The locks are usually flushed q. shift.