Heparin Locks/Flushes

[salaw]

I've worked in NICU for a while now, this is my fourth job in NICU. This is the first one where heparin flushes and locks are used. Isn't this really outdated? I'm curious to know how many of you are using them in your units. And if you think its outdated? I think it is dangerous!

[NICU_RNC, BSN, RN]

For PIV's - we use a saline lock. We switched a few years ago from all heplocks. There are lots of studies out that show there is no difference in how long PIV's last whether you use a hep or saline lock. So best to go with saline to avoid heparin errors.

For central lines (our Broviacs or UVC's) - we use a 1 unit/10 cc hep saline flush.

Our PICC lumens are too small to lock so they are dc'd as soon as the baby is on full feeds, off antibiotics, etc.

[NicuGal, MSN, RN]

We use saline locks on PIV. We usually have a KVO thru our central/PICCs if we aren't using them until we are ready to pull them (ie chronic kid with history of going bad on occasion or just using it for meds).

[NICU_RNC, BSN, RN]

Opps! Don't know what I was doing there...I meant a 1 unit/cc hep saline flush NOT 10! Sorry!

[katierobin23]

We use heplocks still, 6 units/3cc prepared syringes, we flush 0.5ml q4 for PIVs and unused ports on central lines.

[GrowingBabies]

We heplock PIVs and hep flush all lumens on UVCs and PICCs that do not have a continuous infusion.

[Bortaz, MSN, RN]

Why would you not just run a KVO of 1/4NS + 0.25U heparin/100ml, rather than continuously access those central line ports and risk infection?

[GrowingBabies]

We do run KVO rates on the main line but not to the other ports. MDs discretion? I've not seen extra fluids run to ports used intermittently.

[salaw]

Yeah at the last places I have worked, we ran KVO 1 ml an hour or 0.5 ml an hour in lumens or lines that were needed just for meds/access. I just can't believe that hospitals are still using heparin, it is such a dangerous thing, aside from the increased risk of infection.

[GrowingBabies]

Anyone have any leads to good research regarding heparin vs. saline flushes in neonates?

[verniec]

We have two different concentrations of heparin flushes that are prepared by pharmacy. If the baby is over 1.5kg we hepflush PIV's q6h with 0.5cc and for CVL's and PICC lines (bigger than 3fr) we use 1cc q12h.

[SteveNNP, MSN, NP]

My first unit used heparin to flush PIVs. My current unit uses saline prefilled flushes and they last just as long. All our central and PICC lines get 1:1 or 0.5:1 heparin in fluids. We never cap or heplock a central or PICC line.