IV heparin, PCA and central line question..

begalli · Sep 2, 2004

is it ok to disconnect a patient for a shower if he/she is on an IV heparin infusion??

I guess you'd have to, right? Clarify with the MD and get an order if you're not sure.

how often do u flush central lines? TID? BID?

Usually once/shift, but each facility has their own procedures.

are you allowed to piggyback meds through a patients PCA line (if your patient is on a PCA pump recieving morphine)?

At my hospital...absolutely not. Actually no hospital that I've ever been has piggybacked through a PCA line.

Are you looking for subjective answers/opinions to your questions or something concrete and pertaining to your practice? If it's the latter, you'd better check your policies and procedures manuals or simply ask someone, at your facility, who knows.

critcarenurse16 · Sep 2, 2004

I would get clarification from the physician on disconnection of heparin. The PTT may drop to subtherapeutic levels if off too long (over an hr say). As far as central lines and PCA's check your hospitals policy. At our facility we flush unused CL ports daily with heparin 10 units per ml-3ml. If being used we use NS. Check compatibilty of drugs before infusing a PB through a PCA line. I always have a KVO (at least) IV infusing with any PCA even when continuous. Most central line ports need a flow of about 20 ml/hr to maintain patency. Check you CL set. If the drugs are compatible plug the PB into the KVO or primary line. Hope this helps.

is it ok to disconnect a patient for a shower if he/she is on an IV heparin infusion??
also
how often do u flush central lines? TID? BID?
and...
are you allowed to piggyback meds through a patients PCA line (if your patient is on a PCA pump recieving morphine)?

critcarenurse16 · Sep 2, 2004

I guess you'd have to, right? Clarify with the MD and get an order if you're not sure.
Usually once/shift, but each facility has their own procedures.
At my hospital...absolutely not. Actually no hospital that I've ever been has piggybacked through a PCA line.
Are you looking for subjective answers/opinions to your questions or something concrete and pertaining to your practice? If it's the latter, you'd better check your policies and procedures manuals or simply ask someone, at your facility, who knows.

I guess I should clarify my reply after reading this one... You should never PB directly to a PCA line-- that is why you run a primary IV at prescribed hourly rate or at least KVO if none is ordered. Sorry for any confusion.

apaisRN, RN, CRNA · Sep 2, 2004

These are basic nursing questions, not critical care. Are you new to acute care?

RNKPCE · Sep 3, 2004

It would be rare to disconnect a Heparin gtt so patient can shower, and only with an MD order. Fortunately not as many pt on heparin these day since lovenox is avail.

Hospital policy flush central lines q shift

Never piggyback into PCA, our tubing won't even allow it. We must have a primary line going which the PCA is hooked into with a valve so there can be no back flow into PCA. You can run a med into the primary as long as compatible with PCA drug.