Published Oct 11, 2004
My hospital has a protocol to flush triple lumen caths with 2.5cc of heparin, divided among three ports. So I followed the protocol and flushed. Then the next night I was off and laying in bed and remembered that the pt was switched from heparin to lovenox that previous morning. I have not been to work since and am wondering if this would be a problem. Any advice????
NurseStacey143, ADN, RN
flushing with lovenox? Never heard of it. Our flushing protocol is flush with 5 cc NS then 2 cc Hep.
No, the protocol is flushing with heparin, but my concern is that the pt was getting lovenox inj. and I flushed their ports with heparin.
You flush each port with heparin to keep them patent. The lovenox administered sc in the abdominal area is used as a blood thinner to prevent blood clots, don't put the lovenox into the central line. Out central line policy is to flush each port with 5cc of normal saline followed by 2.5cc of heparin in each port and always use a 10cc syringe in the central lines.
I was just concerned because I know your not suppossed to give a combo of heparin and lovenox, or coumadin........basically any combo of blood thinners.
apaisRN, RN, CRNA
The small amt of heparin used as a flush does not usually have a systemic effect. Don't worry about it.
OTOH, my hospital no longer uses heparin flushes, except in dialysis catheters. When a patient has HIT even a flush can be a problem. We flush with saline. If a line gets clogged we use TPA to clear it, but you just put the TPA in and aspirate later, you never actually push the TPA into the patient.
Also, I often have patients therapeutic on heparin while working up to a therapeutic INR with Coumadin. It's not unusual to be on both, briefly.
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