Central Lines???

Nurses General Nursing

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I realize every facility does things differently, but how do you all flush central lines? Some say to put 5 cc's of saline in a 10 cc syringe, flush and follow with heparin. Others don't use heparin. Some require or allow prefilled syringes with saline and heparin mixed. I have a mental block when it comes to flushing central lines. We have a chart, but even finding out which line someone has can be an obstacle! When I question other nurses many seem to not be 100% sure. Thanks for your help!

Just Want To Know If Anyone Knows Of A Web Site On Information On Ports. Any Onfo Would Help. Thx :)

This is a great website with LOTS of links to all kinds of lines and ports: http://www3.nbnet.nb.ca/normap/ivaccess.htm. It's technically for patients with CF but is a fantastic resource. I can't remember if I got it from someone on here or found it on my own while researching, but it's definitely on my favorites!

What about when you're flushing a port before deaccessing it? We (meaning me and my nurses - I'm port-ed) always use 10cc NS and 5cc heparin before taking out the needle. I heard some places are just doing NS on those too, but it kind of scares me to not have heparin in there if it's deaccessed for awhile, especially if it's only being flushed for maintenance once a month...

It really is amazing how every nurse has his/her own way of dealing with central lines - when you get into homecare it gets even MORE crazy - I think every nurse I've had did something a little different (especially when it gets to dressing changes too) and they're all from the same place. Not that any of them are wrong (haha I'd point that out in a heartbeat), it's just funny how many different ways there are to reach the same result!

Specializes in ICU;CCU;Telemetry;L&D;Hospice;ER/Trauma;.

{doing it "your own way" or even according to the infusion nursing society can get you into deep trouble if you are called into a courtroom.}

msdobson:

actually, the infusion nursing society sets the guidelines by which most hospitals perform central line accessing and maintainence. these guidelines are also endorsed by nearly every nursing specialty and jacho. whenever there is a referenced guideline, these are court worthy, and do stand in court if followed....even if the hospital guidelines are different. the exception would be if someone deviated from the standards and performed on their own, a specific step or treatment and there was harm to the patient or there was a line failure due to neglect, etc.

the infusion nursing society is one of the oldest nursing societys and prides itself in the fact that they maintain very strict standards when it comes to infusion therapy. the guidelines that the infusion nursing society sets forth have been used in many court cases, and actually have been used for the plaintiff (as opposed to the defendant) as the standard by which to follow. i would disagree with your statement, then, because of this.

however, whenever there is a litigious event, the usual generally accepted protocol is "what is your hospital's policy".....this may cover the nurse to some degree, but only if the hospital's policy is in accordance with acceptable standards and practices. the infusion nurse's society is the accepted standard.....so doing something within their guidelines is completely okay.

where a nurse may get into trouble is if she/he follows a policy that is clearly out of date or out of guideline.....this is why nurses need to stay abreast of what is the accepted standard, ie ceu's and their nurse managers should be making sure that the guidelines are incorporated into their practice through protocols and policies that are written.

if you ever run into an "outdated" policy, it should be brought to the hospital policy and procedure committee and addressed to be changed with supporting documentation and evidence of what the change should be.

a hospital can be sued for not keeping "up to date", and the nurse who performs that outdated procedure could also be held culpable. crni

Our textbooks say that you need to use 10 cc of NS to flush because of pressure issues within the line.

Our textbooks say that you need to use 10 cc of NS to flush because of pressure issues within the line.

It's not necessarily the 10ml of NS, but rather the size of the syringe that is what is of concern. Theoretically you could flush a TLC with 3ml of NS in a 10ml syringe and you would be fine.....other than the fact that 3ml is not going to do you any good with flushing.

It's not necessarily the 10ml of NS, but rather the size of the syringe that is what is of concern. Theoretically you could flush a TLC with 3ml of NS in a 10ml syringe and you would be fine.....other than the fact that 3ml is not going to do you any good with flushing.

Thanks! I haven't had a lot of contact with central lines (a few PICC's) and I need to review that info because it was last fall when we went over it. So at this point I just remember the basics.

Specializes in ICU, L&D, Home Health.

We flush all central lines with 5 mL NS. The exception to this are PICCs, where we are required to use a 10mL syringe and 10 mL NS (the larger gauge syringe puts less pressure on the catheter). We do not use heparin for flushes, due to fears of HITT. Heparin in our facility is reserved for Vas Caths.

Specializes in cardiac.

They have switched our policy 3 times since I've been there since Feb. of this year. First it was NS followed by Hep. Then it changed to NS only related to the new positive pressure caps. Which I didn't mind so much. But, people were complaing about the caps. So now, back to the old caps and NS only. Hard to keep it straight sometimes and I find I want to use heparin as I was trained to do. Just find out what your unit protocols are concerning central line flushes, and do what is recommended.

hi,

i am an onc RN, and we do central lines up the yang. so, groshong is 10ccNS only w/ exeption to post blood draw, which is then 20cc NS only. mediports and powerports and non-groshong piccs are 10ccNS and 5cc/ 100u hepranized saline (20ccNS/5cc hep post blood). hickmans are the 20ccNS. you have to totally look at your institutions protocols though. good luck!

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