Flushing PICC lines with heparin

[LogCabinMom]

Hello there -hoping someone can point me in the right direction - how do I find the latest literature on locking PICCs with heparin or NS? I infused a pt yesterday with an antibiotic who is getting it daily for 6 weeks. The infusion company RN who placed the PICC line simply told him he needed to flush with heparin at the end of each administration. He has been getting Heparin 100unit/ml 5mls each lumen (double lumen) for about a week now from our ED. This is 1000units /day for 42 days! He is on crutches, approx 55 yrs old, and will be having surgery at some point during the next month. To me, this puts him at a huge risk for bleeding after a fall, and also HIT.

How much heparin is too much? INS policies and procedures 4th ed does mention flushing with heparin, but how much? Our hospital policy has not been updated since 2008, and I am the only one questioning this. I would love some feedback and pointers on this -

thank you!

[Sun0408, ASN, RN]

If we have a line with heparin, we pull off the heparin before we flush or run anything through the lumen. Once we are finished with the lumen, we flush with NS then flush with the heparin. My current facility does above but my last unit only used heparin for HD ports.

You can talk to the PCP or the surgeon to see where they stand.

[moorefun11]

The newer picc lines you use 10ml Ns in a pulse push. We only have used heprin for a port for about 2 years now.

[KelRN215, BSN, RN]

I have always worked in facilities that ONLY used 100 u/mL heparin for ports and only when they are being deaccessed. A PICC that is getting flushed several times a day does not need that much heparin. When I worked in the hospital and now in home care, we flush a PICC with 2-3 mL of 10u/mL heparin following their infusions. Kids who have these or broviacs for oncology purposes, their parents are taught to flush with 2-3 mL of 10u/mL heparin BID.