Central Lines: saline or heparin?

[nursemouse]

Help! What do you flush your basic, non-tunneled double or triple lumen central lines with? Our policy says heparin, most of our nurses are using saline, and much of the literature I've found supports saline. I'm trying to get a policy in place to support what our nurses are doing.

As an add-on, do you have any clotting problems with your central lines (particularly if you use saline)? Thanks! Nursemouse.

[I_Love_Donuts]

In onco/hemato ped, we flush with 10cc NS and then if you need to heplock, we do so with 4 cc (depends on the weight) of Hep. 100IU/ml...But if something is running on mine line, I just flush with NS.

Hope this helps!

[zambezi, BSN, RN]

We flush only if the line is not in use.

We use 3 cc NS. Then 3 cc heparin (10u/1ml).

If the patient has low platelets or other bleeding type issues, we forgo the heparin and just use ns or keep a tko rate going thru the IV.

[Gator,SN]

Where I work, we use heparin to flush a central line. Some nurses use saline first, then heparin, some skip the saline. I've been told to use heaprin to avoid the possibility of a clot. We have prefilled 3cc syringes for both.

[K8RN]

10cc NS followed up by 5cc Heparin 100u/ml. Someone's PICC was good and blocked up the other day, IV RN got an order to put a tPA flush through it...cleared up that clot nicely.

[BarbPick]

I wish I had a dollar for every line I had to de clot because Hep Loc was not used. There are standards of care from The Infusion Nurses Society.

http://www.ins1.org/

[nursemouse]

Thank you so mjuch for all of the help. I'll check out the infusion nurses link. Jeannie:kiss

[Balagtas]

I had a patient who has a central line and he's allergic to heparin so we only flush with 10 cc NS and it did fine, never had a clot problem. Anyway what we usually do is we flush with 10 cc NS first then 3 cc of heparin.

[BarbPick]

Oh Bla Dee Oh Bla Dah Life goes on Ha!

[nursemouse]

thank you so much for your assistance and answers. Literature notwithstanding, it looks like it's overwhelmingly Heparin on this board. I'll admit I didn't expect that, but that's why I asked the question! As usual, you guys have been great. Take care! Nursemouse (Jeannie):blushkiss

[Sue McGann]

We use saline to flush peripheral and central lines. No heparin. One of the benefits are some patients are allergic to heparin and can have nasty allergic responses. Sue:cool:

[Marcus]

Hello nursemouse,

we use a generous ( approx 10-15ml) vol of plain saline per lumen on our multi-lumened lines in our general icu.

We don't use heparin at all for flushing except on haemofiltration lines- Vascaths and so on.

Regards, Marcus