Heparinized vs Nonheparinzed saline in arterial lines

[saranurse]

What are you using in your transudced arterial lines, a Heparized solultion, if so what is your concentration OR nonheparinized saline?

[jjjeep4]

normal saline on central/a lines

[NurseMeg]

We, too, use only normal saline in our arterial line pressure packs. I've never actually had an a-line clot off. Usually when they "go bad"(radial line), it's becasue the patient is bending their wrist too much. One time, though, I was taking care of a donor patient and we used the line for so many labs, it went bad.

[blueheaven]

I was told that the reason we stopped using heparin in all lines was that "studies" show that heparin causes thrombocytopenia when used in lines.

[cardiacRN2006, ADN, RN]

Have not seen any heparin thrombocytopenia as of yet.

My last pt had HIT. The only place he got the heparin from was the dwells in the vas cath. And that's a very small amount. After 2 HD's pts plts went from 250 to 70.

[AdelaideChic]

For our art and cvp pressurized lines we mix 500units in 500cc ns unless pt has a specific condition that would require us just to use the saline pressurized bags. Have not seen any heparin thrombocytopenia as of yet.

Im a new RN, and ive worked on two crit care places for my first two rotations. In the general ICU, normal saline is used, however in the cardio-thoracic ICU (where 95% of pts are post CABG, MVR or AVR) they use the heparin as mentioned above.

Both units use pressurised bags to give about 3ml/hr (more really though, as we use their art lines to take blood regularly for BSL's...).

I have only seen one episode of HITs, and interestingly that was in the cardiac ICU, where a guy was transferred from another (less major) metro hospital with cardiogenic shock (he had EF of 8%..and various other ailments!). However, he was also on bd sc heparin 5000u, so the 3ml/hr was probably minimal in comparison.

Ive always kinda wanted the research of whether one or other was more effective, seems odd two different units in the same hospital (actually they are so close they share walls!) have different protocols.

[danamobile]

my unit has now switched for saline for every line.. art, peripheral iv and central lines! only dialysis lines use sodium citrate, but we are heparin free! (i'm sure it's because of the increased HITT positive patients these days)

[SICU Queen]

Normal saline here as well.

[oneillk1]

What are you using in your transudced arterial lines, a Heparized solultion, if so what is your concentration OR nonheparinized saline?

In the dark depths of australia we use heparinised saline for transduced art and cvp lines unles contraindicated ie pt has Hitts. However changes in practice seem to take a long time to get down here......

[AdelaideChic]

In the dark depths of australia we use heparinised saline for transduced art and cvp lines unles contraindicated ie pt has Hitts. However changes in practice seem to take a long time to get down here......

Not ALL of Australia!!!

As per my post, I have worked in two units of the same (metropolitan, large) hospital in Aust which each have diff protocols - one with heparin, one without...

[a21chdchic]

Nurseboy1

Just love Garfield and the definition of stress. I agree WHOLEHEARTEDLY!!!!!! :rotfl:

[Laban]

All flashes and flash bags normal saline. We only use heparin when ordered specifically. Post CABG patients with heparin bag hanging, it is immediately switched to saline.