We have lost a few arterial lines lately, and are looking at our technique as a possible cause. What size syringes do you use for aspirating from alines? Do you think the size matters? We do not use the drip method, and we do return the first aspirate/waste.
Jan 17, '08
We rarely lose an art line before it's time to pull it. The ones we lose are usually thooe that have been dislodged by a wild child (or a slightly too aggressive dressing change!). We use all sizes of syringe to draw bloodwork, from a 1 mL heparinized gas syringe up to a 20 mL for transplant workups; our patients range from neonates to virtual adults, cardiac, trauma, respiratory and all stops in between. We reinfuse the "waste" drawn off at the beginning. I've also used 3 mL, 5 mL and 10 mL syringes to flush with when the patient's art line is on a pump and not on a pressure bag. Are your flush solutions heparinized? I just glanced at a lit search reported in the AJCC that suggests more lines are lost if the flush solution infusing isn't.
Jan 17, '08
Yes, the flush has heparin.
Jan 18, '08
For our Umbilical a-lines, which are either 3.5 or 5Fr and generally about 20cm long, we use 3ml syringes to aspirate and flush, although our ABG syringes are 1cc. For our peripheral art lines, which are 24g IV catheters, we use 1cc ONLY.
Jul 5, '08
we use the 'vamp' system. it is a closed system you put in line when setting up the tubing. it enables you to draw off a waste, obtain sample and then return the 'waste'. its made by edwards life sciences. it is also needleless. it comes in an adult and pediatric size (basically different amts of waste pulled off) I think we lose less art line using this system. we stopped using heparin and papaverine in the flush bags and i think this had more of an impact on line patency.
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