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Implanted Ports & Heparin Flushes

Oncology   (8,768 Views | 16 Replies)

HMarie13 has 5 years experience and specializes in Vascular Access Nurse.

2,754 Profile Views; 40 Posts

Hello everyone! I wanted to get information on others policies...I have found some online but thought this would also help. I have to update our flush protocols and need to know what other hospitals do and have articles to back it. So far I have found nothing in INS but I am still looking. Any other places good to check?

When accessing an implanted port, do you waste the first 5mL of blood removed to discard the old heparin or check for blood and flush the line?

How often do you flush with heparin?

Every 12 hours?

After medications through out the day?

After blood draws? Contrast?

Thanks for any responses! Our educators are skittish because of HIT and don't think we should use heparin.

I asked our sales rep for the port brand we use and they suggested "per hospital policy" :facepalm:

Edited by HMarie13

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Maritimer has 20 years experience and specializes in rural, camp, telephone triage, abstraction.

29 Posts; 5,642 Profile Views

I haven't flushed routinely with heparin in a long time due to HIT--we generally just use saline with our Groshong ports unless we have had clotting issues, in which case we will add low-dose heparin. We do still use heparin flushes on our non-Groshong tunneled catheters and PICCs. Not sure where to find an article, though; our policies don't have resources cited.

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10 Followers; 3,579 Posts; 26,099 Profile Views

When accessing an implanted port, do you waste the first 5mL of blood removed to discard the old heparin or check for blood and flush the line? No, it isn't necessary unless you are drawing labs

How often do you flush with heparin? Only when de-accessing the port.

Every 12 hours? No

After medications through out the day? 10 ml Normal Saline

After blood draws? 20ml Normal Saline

Contrast? 10ml Normal Saline. If dual port flush both sides.

Hope this helps.

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HMarie13 has 5 years experience and specializes in Vascular Access Nurse.

40 Posts; 2,754 Profile Views

Yes thank you Wuzzie. I am just trying to get of feel of how others utilize heparin.

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HMarie13 has 5 years experience and specializes in Vascular Access Nurse.

40 Posts; 2,754 Profile Views

Thank you Maritimer! Yeah we do not use heparin on the Groshong PICCs, but out ports are PowerPorts...They require heparin its just an issue of how to word how often to use it.

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291 Posts; 7,076 Profile Views

Thank you! Yeah we do not use heparin on the Groshong PICCs, but out ports are PowerPorts...They require heparin its just an issue of how to word how often to use it.

We use PowerPorts and only use heparin when deaccessing. We flush with 10 ml saline every 8 hours, 20 ml saline after blood draws.

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IVRUS has 32 years experience as a BSN, RN and specializes in Vascular Access.

1,026 Posts; 20,693 Profile Views

Standard 40, practice criteria I-6 speaks to HIT. [pg S78) In addition, Standard 28- Practice criteria F speaks to flushing and locking with Saline and / or Heparin flush. Since Heparin flush solution is the only FDA approved locking solution to prevent Fibrin buildup, serious considerations need to made about its use, or Saline only use.

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46 Posts; 934 Profile Views

Wow, our policy is different. I have worked on my oncology med surg unit for 14 years and getting a port access/flush refresher course next week. Our policy hasnt changed that I know of. We always flush with 10cc saline 5cc low dose heparin (I know they changed the hep concentration as it is different from our picc heparin now--cant recall off hand) every time we give an med through it or labs and before we deaccess it. I will ask about our policy at the class next week.

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NanikRN specializes in Oncology, Rehab, Public Health, Med Surg.

392 Posts; 7,841 Profile Views

We use PowerPorts and only use heparin when deaccessing. We flush with 10 ml saline every 8 hours, 20 ml saline after blood draws.

Same at our unit

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AgentBeast has 6 years experience as a BSN, RN and specializes in Cardiology and ER Nursing.

1,971 Posts; 21,864 Profile Views

Implanted ports get flushed with 5ml of 100units per ml heparin when deaccessed, All others are flushed with saline. Except for dialysis Caths are locked with sodium citrate.

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46 Posts; 934 Profile Views

during my port access refresher class I asked about our policy. Our hospital is switching to only power ports so they can be used for CT scans but we are to continue flushing with 10cc saline (20cc if lab draws) and always 5 units of heparin flush every time we use the port (not sure of concentration off hand) even if we are giving morphine q2hr ivp or something that frequent-unless continuous infusion of course. I asked about HIT and the instructor said its too low of a dose to cause problems.

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IVRUS has 32 years experience as a BSN, RN and specializes in Vascular Access.

1,026 Posts; 20,693 Profile Views

during my port access refresher class I asked about our policy. Our hospital is switching to only power ports so they can be used for CT scans but we are to continue flushing with 10cc saline (20cc if lab draws) and always 5 units of heparin flush every time we use the port (not sure of concentration off hand) even if we are giving morphine q2hr ivp or something that frequent-unless continuous infusion of course. I asked about HIT and the instructor said its too low of a dose to cause problems.

HIT is NOT concentration dependent.

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