INS Guidelines

[A pharmacist]

Hello All,

I've been tasked with writing protocols for catheter flushing at our hospital. I don't know tons about catheters, but I'm familiar with the debate and most of the supporting evidence. My preceptor wishes to go with the Heparin 10U/ml for the most part despite the leaning toward NS out in the literature.

I have a huge hole in my research and that is what's contained in the INS Standards of Practice. Most guidelines are published with free access, but this one is not and quite frankly it's a bit perturbing they're asking $70 for their recommendations.

That aside, I have a couple of questions if I may: Those familiar with these guidelines... would they help in justifying the 10U/ml? If so, is there anywhere to obtain an electronic version or SOMETHING that alteast summarizes their recommendations? I don't need to know everything about catheters, just that which pertains to evidence based flushing recommendations.

Thanks in advance for any input.

[IVRUS, BSN, RN]

Hello All,

I've been tasked with writing protocols for catheter flushing at our hospital. I don't know tons about catheters, but I'm familiar with the debate and most of the supporting evidence. My preceptor wishes to go with the Heparin 10U/ml for the most part despite the leaning toward NS out in the literature.

I have a huge hole in my research and that is what's contained in the INS Standards of Practice. Most guidelines are published with free access, but this one is not and quite frankly it's a bit perturbing they're asking $70 for their recommendations.

That aside, I have a couple of questions if I may: Those familiar with these guidelines... would they help in justifying the 10U/ml? If so, is there anywhere to obtain an electronic version or SOMETHING that alteast summarizes their recommendations? I don't need to know everything about catheters, just that which pertains to evidence based flushing recommendations.

Thanks in advance for any input.

The rule of thumb is to always use the lowest concentration of heparin Flush solution possible. Open ended IV catheters, or ones without a valve, require that final Heparin to prevent fibrin buildup and catheter occlusion at catheter's tip end. There really isn't a substitute in the USA for this at this time. Saline only will result in increase costs as Cathflo will be needed repeatedly. The only time INS recommends 100unit per ml Heparin flush is in your implanted ports. I realize that there recommendations are for fee, but since this organization is a benchmark for IV therapy and Infusion nurses use it everyday... It is no different that you subscribing to Trissels, or another pharmacology book, IMHO.

Hope this helps.

[Madam PICC]

The INS has now offered the new standards of practice for the e readers. The Barnes and nobles has a free app for computer and the cost the of the guidelines is only 15.00 instead of the book format it is much more reasonobly priced. Hope this will help.