Flushing Ports - page 2

Our facility does not have a standard of procedure written with flushing ports. Our pt. has a triple lumen subclavian. It has always been my practice to flush with 5cc NS and then 3CC of Heparin... Read More

  1. by   begalli
    The only lines we hep lock are shileys and thats usually done by a dialysis RN unless we need to access the line for whatever reason (eg: returning blood after CVVH clots or is d/c'd).

    We don't use heparin for the same reason as someone else mentioned...heparin induced thrombocytopenia. Seems like LOTS of patients are prone to this in the ICU.
  2. by   curleysue
    Quote from Mystery5
    Do you mind me asking why you have a port???
    In response to Mystery5 question about why I have a port, I don't at all mind telling you why.

    During college for my BSN I contracted viral meningitis and was hospitalized for two weeks on major steriods. A year later I contracted viral meningitis again and was hospitalized for a month, it did some damage to my heart, my hearing and my immune system. Since then I have had multiple, multiple medical problems. Just to name a few: Bilateral Pulmonary Embolisms, DVT X 4, pnemonia X 8, fibromyalgia, Supraventricular Tachycardia (treated successfully with ablation) and multiple surgeries for polycystic ovarian disease and endometriosis.

    So, as you can see because of my frequent hospitalizations my vein slowly became none exsistant. Absolutely no peripheral veins. So after my Pulmonary embolisms instead of getting central lines every time I was admitted my hematologist said I was a very high risk because I didn't have any venous access and in an emergency it would be a lot of work to put in a line quickly. So, I got my first port. The first one I had was very positional, low profile port that gradually ended up in my armpit. So, I went to a vascular surgeon for my second port (went to a general surgeon for my first) and he did an awsome job. I asked for the biggest port available cause I am not that skinny. Well this port has lasted 2 years and many sticks.

    As of now. I get a PT, PTT done once a week (drawn from my port) and because I am hypomagnesiumia I get IV mag sulfate twice a week. So, I wouldn't be able to get all this without my port. I love my port, its so easy and draws blood really well. I think I will need a port for most of my life.

    There is one thing that I was going to ask you nurses about my port. When they do CT scans a lot of times they need contrast given. Well because I still don't have any peripheral veins I wonder if they should and could use my port. I am just scared that because of the high rate of speed they have to push that contrast in: it would hurt the port. Plus that contrast is so viscus (sp?). I think I have had contrast in it once, but they had to push it in slower and they didn't get as good as reading as they wished. What do you guys think? Is it safe to give IV contrast through a port?

    Sorry this is so long I just wanted to clearly explain why I have a port.

    Talk to you later. Curleysue
  3. by   CandyMSN
    The facility in which I am employed has specific guidelines/protocol for flushing central lines, particularly triple lumens since that is the focus of your concern. Policy states that for triple lumens, each port must be flushed with 3 cc of heparinized saline with a dilution of 100 units per 1 cc (or ml) a minimum of once a day unless directed otherwise. That means that a total of 900 units of heparinized saline will be introduced into a triple lumen catheter during a single procedure. Another member spoke of concerns regarding HITTS. To address that issue, before flushing the catherter, ALL CONTENTS WITHIN THE CATHETER MUST FIRST BE ASPIRATED! I can honestly say that I was once out of compliane. I thought the dilution was 100 units of heparin per 3 cc of normal saline. After checking various sources, it appears that many facilities prescribe to 100 units heparin per 1 cc normal saline method (10 units of heparin per 1 cc normal saline for children). It is also suggested to use a separate syringe for each lumen/port.

    Quote from nightngale1998
    Our facility does not have a standard of procedure written with flushing ports. Our pt. has a triple lumen subclavian. It has always been my practice to flush with 5cc NS and then 3CC of Heparin flush. Another RN says we can just do the Heparin since we are not using a fluid in between.

    Opinions? What does your policy and procedure state?

    Thanks in advance.