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.

[TCJan]

Whats the Regs. for LPN's flushing Picc Lines, with 3cc of 100u/cc of Heparin. These Rehab. units in nursing homes are admitting high acuity pts. from hospitals and expecting LPN's to care for their Picc lines for IV ATB therapy. I thought we couldn't give Heparin IV. When I worked on sub-acute unit in a hospital, we had a IV course and we could flush with a pre-mixed 3% sol.of Hepariin/NS. , but usually the R.N.'s cared for the Picc lines and we cared for the pheripheral lines. Anyone know the answer.??????

[CoffeeRTC, BSN, RN]

Interesting to see the responses. We use saline and heparin 5cc/2cc. I always seem to use more. We do see a lot of clotting or occlusion in our LTC, mostly because they aren't flushed per order not using the Heparin.

[Nurse1202]

I work in 2 different facilities, but their policies are the same: Triple lumen catheters 4cc NS. PICC/Midlines: 4cc NS/2.5cc Heparin, unless pt has allergy. 10 cc NS flush after blood draw, no matter the type of access.

[BadBird, BSN, RN]

We only flush with Saline now, even for arterial lines.

[Burnt Out, ASN, RN]

For routine maintenance of a central line we flush with 1-3cc of Heparin 10 Unit/1 ml. After blood draws, we flush with 10-20 cc of NS and 1 ml of hep flush (10u/ml).

We only use Heparin 100 U/ml on Ports.

[unknown99, BSN, RN]

We flush each lumen with 5cc saline then 5cc heparin

[Gldngrl]

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/

I checked out the site...is there any way to access the subject matter w/o purchasing the book? I clicked on all the links but w/o success. Thanks.

[kc ccurn]

flush with normal saline 2cc q8 hr and prn for central and peripheral lines. PICC lines get heparin q12 hrs.

[kyutnurse]

PLEASE CHECK THE FACILITY'S POLICY AND PROCEDURES BOOK!!!!!!!

THEY SHOULD HAVE A CENTRAL LINE STANDING ORDER.

ria

[sweetielin]

10cc ns and 5cc heparin

[NurseyBaby'05, BSN, RN]

10 mL NS per port 1 x shift or tid. As long as everyone does this at the beginning of his/her shift, we very rarely have problems with them clotting off. Occasionally we won't get good blood return out of one of the ports, but if we can get out of one of the other ones, we leave it go. If there's no blood return in any of the ports or if one of them doesn't flush, we get Cathflow ordered for the IV team to administer. That usually clears it right up.

[NursesRock29]

Whats the Regs. for LPN's flushing Picc Lines, with 3cc of 100u/cc of Heparin. These Rehab. units in nursing homes are admitting high acuity pts. from hospitals and expecting LPN's to care for their Picc lines for IV ATB therapy. I thought we couldn't give Heparin IV. When I worked on sub-acute unit in a hospital, we had a IV course and we could flush with a pre-mixed 3% sol.of Hepariin/NS. , but usually the R.N.'s cared for the Picc lines and we cared for the pheripheral lines. Anyone know the answer.??????

It depends on your state and hospital policies. I am an LPN and I have done done it for years...and the hospital I work for offers regular training for things like that in case I felt uncomfortable. Can you go to your manager and tell them your concerns?

As for a definite yes or no, there is no set rule on you flushing the line.