central venous catheters/portacaths

[fionaj]

I am reviewing policies regarding the care of portacaths and cvc's in the paediatric population. Please reply if you can contribute to the following issues:

How often do you change IV lives in paediatric patients?

What is your proceedure regarding accessing cvc's and portacaths?

Thanks

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[juliekrn]

Have you gotten any replies? We are interested in this information as well. Especially, blood sampling from implanted ports.

[bbnurse]

CDC has IV guidelines for peds pts. but stops short of specific requirements. It is being studied at many places around the country. Check the CDC site, the FDA site, and IV Therapy nursing site for info'. Ours is the same right now as for adults cause the research is so scarce... Good hunting.

[NursediRN]

We have instituted a policy in our hospital we flush infusa ports and CVC using the SASH method. When initially accessing the port we flush with saline and aspirate back approximately 5 cc of blood, draw our lab work, flush with 10 cc of saline and lock off with 5 cc of heparin 100 units per cc. This is if the port is only accessed twice a month. If we have multiple blood draws we usually aspirate first then use the SASH method, especially in CVC lines. In children with multiple blood draws we usually lock with 5cc of heparin 10 units per cc to decrease the amount of heparin given to the kids. In our PICU the M.Ds usually keep a continuous drip of IV fluids with 1/4 unit of heparin per cc to keep the line patent and we just draw the blood and reattach the IV fluids. Hope this information helps

[NursediRN]

Needed to add on my previous that we did still draw 5 cc of blood from the lines. Also if it is a continuous fluid line with Heparin we may give the blood back if the child is anemic. When accessing the ports we use sterile method and Huber needles when spiking. We use alcohol and betadine on the ports of CVC lines. We also change our dressings every day.