PICC Lines With Heparin

iluvivt, BSN, RN · Jun 24, 2011

Tx you IVRUS...I was just going to correct that positive pressure cap statement.. yes the cap does not apply pressure..it is rather designed to positively displace fluid upon syringe disconnection.. It make no sense at all to discard heparin on any CVC except a hemodialysis catheter and its unnecessary. If a facility has concerns about HIT they just need to eliminate the Heparin altogether. The INS guideline that recommends using a Heparin flush on all CVCs is backed up by tons of evidence. The benefit far outweighs the risk

FlyingScot, RN · Jun 24, 2011

You wear a mask, place a sterile field and wear sterile gloves to flush an IV catheter? Hmmm... No studies out there which show that this is the norm, or standard. And, these steps alone are NOT enough, as the increase infection risks will come from increasing hub manipulation. The way "we" do it Follows INS guidelines. Infusion Nurses Society that is.

I am drawing blood not just flushing catheters and I work with cancer patients so this is our facility's policy. Because I'm drawing blood aspirating the heparin is not an extra step so there is no additional hub manipulation. We have an extremely low infection rate and I draw from approximately 400 CVADs per month. I'm sorry if you don't agree with it but it works for us. And I'm well aware of what the INS is but thanks for the clarification anyway. Have a nice weekend.

K+MgSO4, BSN · Jun 25, 2011

A CLC2000 cap is a positive displacement device, not positive pressure, and yes, though these claim to enable you to eliminate heparin flush in open ended IV catheters, I don't see it working well in many settings. How much Cathflo have you used since this new cap was implemented?

OK my apologies for the wrong terminology. I am not familar with the term Cathflo I am assuming it is a brand name that I am not familiar with here in Australia. Can you explain?

IVRUS, BSN, RN · Jun 25, 2011

OK my apologies for the wrong terminology. I am not familar with the term Cathflo I am assuming it is a brand name that I am not familiar with here in Australia. Can you explain?

Cathflo Activase (Alteplase) is indicated for the restoration of function to central venous access devices (CVADs).

It will lyse fibrin or thrombus formations that cause catheter clotting.

K+MgSO4, BSN · Jun 26, 2011

OK Alteplase cool thanks for that. I think I have used it once in the last year. have an average of 3 PICCs or CVC a week.

xtxrn, ASN, RN · Jul 25, 2011

When I had a PICC last spring, they would flush the heparin any time they needed to do labs, give blood/platelets/etc. When done, the rest of the SASH was done. Some nurses used the CVD dressing kits, with the masks and and some didn't. I had no problems with sepsis from the PICC. (I did from a weird outer ear infection that came from nowhere, but not the easiest way to get me sicker at that time- the PICC !!! LOL ). The heparin was 10u/cc, so low dose pedi concentration. I didn't have a high pressure PICC. I don't remember the cap, but also don't remember it being anything different than a cap at the end of a subclavian. :)