Flushing PICC lines


What is the current standard of practice for flushing a PICC line after an antibiotic is infused? Specifically, should heparin always be used, as in the SASH method, if the MD dos not specify? Would it ever be acceptable to only use sterile saline instead?

Please advise.


Sun0408, ASN, RN

1,761 Posts

Specializes in Trauma Surgical ICU. Has 4 years experience.

I never used sterile saline and heparin flushes vs NS flushes are per facility. My last hospital used heparin, my current, just NS. This is not a always or never answer except with cleaning the ports hehe :)

blondy2061h, MSN, RN

1 Article; 4,094 Posts

Specializes in Oncology. Has 15 years experience.

Depends on facility policy. We don't use heparin with PICCs at all anymore- just 10ml NS.


4 Posts

thanks for your input.




901 Posts

Has 5 years experience.

At least one 10cc NS flush, no heparin where I work.

Specializes in Emergency/Cath Lab. Has 6 years experience.

If you use it a lot please don't put heparin in every time. Why load them up with it?


36 Posts

Has 1 years experience.

Our policy is to flush each lumen of a PICC line with 10cc normal saline followed by 200 units heparin every twelve hours. Normal saline is used for routine flushes before/after fluid/medicine administration.


1,049 Posts

Specializes in Vascular Access. Has 32 years experience.

Your first objective is to look at your facilities P&P manual as it should be delineated in a policy. Heparin flush is the ONLY locking solution currently used in the US. Therefore, any open-ended or non-valved IV catheter should have this as its final flushing agent. INS recommended a 10unit per ml heparin flush on these IV catheters, and you should use a 100unit per ml flush when 'locking" an implanted port which is open-ended. Using only saline on an open-ended IV catheter over 3 inches will cause you to use a lot of Cathflo since occlusions will be the unfortunate result.

Now, what does your policy say? Check it out and get back with us.


264 Posts

At my facility, we use the SASH method when administering IV meds. If there are no meds to be administered, we just flush the line q12h with NS and heparin. If heparin is contraindicated, we use 2 10ml NS flushes.


4 Posts

The policy states to use the SAS (saline, antibiotic, saline) procedure. I learned the SASH method, however, which is why I was wondering. Other than my textbooks, which are now probably out of date, can you recommend a good website that may advise me of this and other questions related to IVs?



Specializes in Cardiac. Has 2 years experience.

We flush each port daily with 10cc NS and 3CC heparin, it comes up on our MAR. Then if we give an antibiotic or med, we use 10cc before and after per our hospital policy. I know I learned SASH too in school, however, it doesn't always apply depending on the facility where you work.