heparin drips

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Heparin - does it have to be ran completely by itself?

Let's say the pt is on a heparin drip and is supposed to be getting 5ml/hr

Is it safe to run it concurrently? Like with NS in line A at 25 ml/hr and the heparin in line B @ 5ml/hr?

Or is it safe to run in 2 separate pumps at the Y site? One with heparin only and one with NS only?

No matter if you are running it alone, or concurrent, or at a Y site.. aren't you only getting the 5ml of heparin?

Specializes in Medical-Surgical/Float Pool/Stepdown.
Baxter makes a premixed bag for drips which is heparin with NS. I have no idea where your pharmacist got the idea that they are incompatible.

It shows up that way on the IV compatibility section on my work's Micromedix EMR link/program too. Incompatibility may not be the best word (this is what the symbol means on Micromedix though that shows up next to it). More of a decreased effectiveness. I just think it's kinda cool the way medications interact together, that's all!

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Specializes in critical care.

It appears there is a difference between NSS and D5 when mixed with heparin. I remember hearing this but wanted to find research before commenting.

Effectiveness of Unfractionated Heparin in Normal Saline versus Dextrose for Achieving and Maintaining Therapeutic Anti-Factor Xa Levels in Patients ... - PubMed - NCBI

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From what I understand heparin is not compatible with normal saline but it is compatible with 1/2 normal saline. It's the osmolarity of the two combined that decreases the heparin's effectiveness by 30 to 50%. Loves me some pharmacology! :wacky:

Incorrect per every PharmD. I've ever worked with. At a previous job, we'd often have the pharmacy mix heparin with NS instead of D5 for people with severe hyperglycemia. It is somewhat more stable in D5, but it is absolutely compatible with NS.

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Specializes in ER, Pediatric Transplant, PICU.

I had no idea heparin could cause such a rowdy discussion!

I have nothing to offer other than my facility has a policy that its should be ran alone. (Not saying that it always happens that way..)

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I do know that heparin and insulin are also compatible...

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Specializes in Pediatrics.

A lot of great info has been brought up (and debated!) in previous posts. Back to the original question of the poster though I think several points are important to keep in mind...

1. Run heparin (along with all drips like insulin, etc.) in a dedicated line if possible (along with following any policies/procedures at your facility).

2. If you have more meds to give than IVs consult compatibility resources at your facility (like micromedix) or your pharmacist. I also suggest labeling all tubing close to the patient to avoid confusion, Y the tubing close to the patient, and avoid bolusing through a line with a drip (like another poster mentioned).

Great question! :)

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Heparin - does it have to be ran completely by itself?
Certain drips are compatible with heparin; however, it should have its own line as other posters have sagely mentioned.
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Certain drips are compatible with heparin; however, it should have its own line as other posters have sagely mentioned.

Why? If they are compatible, and you aren't bolusing off of the pump, why should it have its own line?

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Specializes in SICU.
Why? If they are compatible, and you aren't bolusing off of the pump, why should it have its own line?

Because heparin is a high alert medication and this quite simply, is being prudent and safe

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Because heparin is a high alert medication and this quite simply, is being prudent and safe

Thank you, I'm well that heparin is a high alert medication. However, as many high alert medications are often infused together, this doesn't explain why heparin should have a dedicated line.

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Specializes in SICU.
Thank you, I'm well that heparin is a high alert medication. However, as many high alert medications are often infused together, this doesn't explain why heparin should have a dedicated line.

What other high alert medication that can cause profuse bleeding do we routinely give "infused together "? Also are you asking from a critical care point of view or RNF ?

ETA: by line, are people talking about the central line lumens? Because that is a different story and no: heparin does not need a dedicated lumen like TPN. Otherwise a stopcock will solve all the problems

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What other high alert medication that can cause profuse bleeding do we routinely give "infused together "? Also are you asking from a critical care point of view or RNF ?

How exactly will infusing heparin with compatible medications increase the bleeding risk?

ETA: by line, are people talking about the central line lumens? Because that is a different story and no: heparin does not need a dedicated lumen like TPN. Otherwise a stopcock will solve all the problems

How is it different if it's infused through a central line?

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