central line flushing do you aspirate?

[purseOnalityRN]

Hi there everyone! Sorry if I'm asking a retarded question - haven't had any experience dealing with central lines before... My pt has a left central line triple lumen... Our hospital policy is Flush with 5cc NS and follow with 3cc heparin lock flush.. I've just been reading up and text says to aspirate before flushing... Is that common practice? And how often do you change dressings? Our hospital is 48-72 hours prn.. Do you use transparent or gauze? Thank you!

[11:11]

Theres no such thing as a dumb question in nursing although many could argue that.

Follow your unit-employer policy.

Aside from that Ive heard of many ways and reasons on how to flush a central line.

Aspirating for the most part helps assess placement and patency. I know of some who will aspirate heparin out before flushing with saline so the patient doesnt recieve it systemicly.

The last unit I worked on had an entire policy on how much heparin to use for what type of line.

The unit I'm on currently doesnt use heparin at all but we flush unused lumens regularly. In home healthcare I would think you'd have to use heparin to avoid the fibrin head from progressing up the lumen but I'm not current on that type of care.

Perhaps you could presesnt this question to the forum of your specialty-

HTH

11

[RN92]

Experts are constantly changing their minds. Currently, at least where I work, it is not enouraged to cover central lite sites with gauze - just a transparent dsg/tegaderm. This way you can see/assess site for sx infection. C-line dsg should be changed within 24 hrs of intial placement then about 3xwk.

[lady_jh_98]

Aspirating central lines is used to check patency of the line. As far as dressing change each facility has it's own policy. The facility I work at just changed their's. Now we do central line dressing changes once a week (it used to be Q 3 days). Plus we do gauze dressings.

[lil' girl, LPN]

We were taught to flush, and dressing changed Q4days, oops and yes aspirate to check placement

[wonderbee, BSN, RN]

In school they're teaching us to aspirate to reduce heparin push.

[nursepearl]

I work in oncology where many of our patients are neutropenic, we do central lines changes everyday. Most of our patients come in with central lines or have one placed while on our floor. only certain lines are flushed with heparin on our floor....and right now i cant remember which ones. Anyway, i would go by your floor protocal.

[stickyfroggie]

I too work in oncology. We flush PICC lines with 10cc NS, and follow with 200 units of Heparin (2cc). Same for Hickmans. Groshongs only get 10cc saline flushes. Port a caths get 10cc saline and 500 units of Heparin.

All central line dressing and cap changes are done MWF. Lines not in use are flushed daily.

Some will draw out heparin before flushing to reduce systemic exposure but it depends on the patients coag status because sometimes it may not even make a difference.

[nurseygrrl, LPN]

Found this pretty handy little table online...

http://tinyurl.com/6skfh

[Aneroo, LPN]

The protocol at the hospital I am doing clinical at is to aspirate for blood return, flush with 5-10cc saline, then lock with 1.5ml heparin. Unless we're doing labs, I do not waste the blood from the return, I return it to the patient. We use a transparent dressing so it's easier to watch for complications, and standard changing is q72 hours or as needed. There are other protocols for the first 72 hours or so post-insertion. -Andrea

[plumrn, BSN, RN]

Great website HerEyes73! Thanks!

[lynn27]

Yes, Thanks sooo much, HerEyes73! Very helpful!