IV heparin question

[cherilee]

when infusing heparin, how do you determine which port you will infuse it in.. when you have a central line? And can you infuse heparin only through one line?

One more iv question, today I had someones iv tube create negative pressure, where blood was backing up alot, how to avoid that?

thanks in advance..

Lisa

[iluvivt, BSN, RN]

Are you using a PICC or a dual or triple lumen CVC. Most triple lumens have 2 18 gauge lumens and the distal lumen is usually a 16 gauge. these vary by manufacturer. So it depends on what else you are using the line for. If iI also had to give blood ( or something viscous) Iwould save my 16 gauge for that. If I had frequent blood draws I would use either the medial or distal for the heparin so I could draw from the proximal.try to give TPN

in the distal lumen. So look at what you are going to be doing and select the most appropriate lumen. To prevent backup of blood keep gravity lines at least 3 feet above level of right atrium, have pt keep iv site arm below the level of the heart especially when walking to the bathroom,if able take BP on other arm,flush prn. hope this helps

[cherilee]

thanks so much for your reply.

so with any central line, double or triple lumen, they are seperate right up until where the line ends... correct? do they all end up in the vena cava? If not, what exactly is distal?

the only number I remember seeing on this picc line was 5. what was the five referring to? And how to tell what gauge the lumens are? doesnt it usually say right on the lumen or clamp??

[iluvivt, BSN, RN]

thanks so much for your reply.

so with any central line, double or triple lumen, they are seperate right up until where the line ends... correct? do they all end up in the vena cava? If not, what exactly is distal?

the only number I remember seeing on this picc line was 5. what was the five referring to? And how to tell what gauge the lumens are? doesnt it usually say right on the lumen or clamp??

Yes that is correct....the lumens are seperate all the way up. At the end of the catheter they either have a slit for an opening (groshong design) staggered opening for each lumen or if open-ended design the catheter just ends and the infusates mix with the blood. the optimal tip placement for most central lines is the distal superior vena cava. Some MDs want the dialysis catheters in the right atrium (cotroversial Subject). The 5 referred to the french size of the catheter. All catheters of any kind are classified by French size. common PICC sizes are 4Fr,5Fr and 6Fr. do not worry too much about the gauge sizes just remember on mutilumen lines the distal lumen is usually the largest....flush it before you use andf if it flushes with ease..go for it anything else i can help you with just ask mary