How to flush a POC

[mervat]

Hi, I currently work on oncology unit and we flush POC with normal saline, we do not use heparin.

Im trying to do a study about the use and benifets of heparin to flush a POC, we noticed that many patients coming back for chemotherapy have no blood return from the POC, therefore we have to TPA it.

I need to know what's the policy in your hospital to flush a POC and if use heparin.

Thank you for your help

[iluvivt, BSN, RN]

Are you talking about a PICC or venous access port or other type of CVC....Clarify and I can answer your questions and tell you the current recommendations

[mervat]

Hi, thank you for replying

Im talking about the Port-A-Cath

[IVRUS, BSN, RN]

Hi, I currently work on oncology unit and we flush POC with normal saline, we do not use heparin.

Im trying to do a study about the use and benifets of heparin to flush a POC, we noticed that many patients coming back for chemotherapy have no blood return from the POC, therefore we have to TPA it.

I need to know what's the policy in your hospital to flush a POC and if use heparin.

Thank you for your help

Are your ports Groshongs?

All Groshong catheters only need NS flushing due to their valved, closed end.

However, a non-valved, or open ended port needs heparinization to prevent occlusions. Infusion Nurses Society (INS) recommends not only heparin flushing these lines, but using 100 units per ml too. Most other catheters over 3 inches in length which are non-valved only require 10 unit per ml heparin flush concentration. You need to speak with your hospital/clinical nursing in charge to get these protocals changed. Why go to the expense and risks of infusing Cathflo in a line which may not have occluded if it was cared for appropriately in the first place?

Hope this helps.

[iluvivt, BSN, RN]

Yes on de-access the final flush on ports is generally 100 units per ml of Heparin (5 ml)....if it is locked off and being used you can use low dose heaprin (10 unit per ml)....there are so many studies already done on this and INS has made their catheter care flushing guideline cards which were published in 2008...so the studies are out there that heparin will help in keeping your occlusion rate lower and the catheter patent. the cards make no distiction between valved port catheters and non-valved..the same flush is recommended ...we do the same where I work

[Alloush, BSN, MSN]

Salam

most of my patients have Polysite ... our routine is flushing the polysite with 500u heparin in 5ml NSS IVP BID. and we use the same concentration before deaccessing the needle.

if the patient weighs less than 10 kilo grams we flush the polysite with 50 u heparin in 5ml NSS IVP BID. and we use the same concentration before deaccessing the needle.

we ran a trial to flush the polysite with 5ml NSS Q8hrs. but it failed. most of the polysites started to get blocked or at least we had difficulties in withdrawing blood.

hope i was useful :)