Please help! I don't understand heparin flush 5ml

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Hi,

I had clinical today and my patient had an order for a 10ml saline flush and a 5ml (100 units/ml) heparin flush immediately after with a port-a-cath. I am confused because of the amount of heparin (5ml seems like a lot more than that little line coming out of her port-a-cath) and my teacher gave me a "Unsatifactory" day today because of my lack of knowledge r/t heparin flushing a port-a-cath. For some reason my teacher questioned the dose, saying that it was too much heparin. (this is for an 8y/o 37.5kg) But according to my resources this is pretty standard in many facilities. So can anyone tell me why it's so much compared to flushing a PIV or PICC even? Or, is there a good resource I can look at regarding heparin flushing in general? I had a hard time finding the safe doses of heparin as well. It is my understanding that this heparin flush is for keeping the line open, not for systemic coagulation issues, however it seems that with the amount given it would affect the system as well. You can probably tell I'm confused... Any help is appreciated, I might not graduate because of this :(

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I did a little research online. I found a document from Phoenix Children's Hospital on how to care for a Port-a-Cath.

http://www.phoenixchildrens.com/emily-center/child-health-topics/handouts/Port-Access-810.pdf

I also looked up the manufacturers website, but was not able to see the use instructions. I used to work homecare, and we would go by the manufacturer's care and use guides. So, depending on the exact brand and whether it is a single or dual lumen, etc. it is impossible to know for sure. You can always phone the manufacturer's 800 number for definitive answers to your questions. As I recall with my peds cases in home care, this is a normal amount of hep lock (5 mL). Also, the article I gave you the link to advises exactly that amount.

Hope this helps a bit...

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I did a little research online. I found a document from Phoenix Children's Hospital on how to care for a Port-a-Cath.

http://www.phoenixchildrens.com/emily-center/child-health-topics/handouts/Port-Access-810.pdf

I also looked up the manufacturers website, but was not able to see the use instructions. I used to work homecare, and we would go by the manufacturer's care and use guides. So, depending on the exact brand and whether it is a single or dual lumen, etc. it is impossible to know for sure. You can always phone the manufacturer's 800 number for definitive answers to your questions. As I recall with my peds cases in home care, this is a normal amount of hep lock (5 mL). Also, the article I gave you the link to advises exactly that amount.

Hope this helps a bit...

Thank you so much for this link, it is very helpful to me! I'm also trying to figure out the difference between a large (5ml) heparin flush to maintain line patency and heparin that one would receive for preventing systemic coagulation. Is it just a different drug concentration?

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Specializes in IMCU.

Good questions. I found this online:

http://nursing.uchc.edu/nursing_standards/docs/Central%20Lines%20and%20Implanted%20Ports%20-%20Heparin,Normal%20Saline%20Flush.pdf

Pg 2 has guidelines and concentrations for central lines.

Obviously for information only.

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Good questions. I found this online:

http://nursing.uchc.edu/nursing_standards/docs/Central%20Lines%20and%20Implanted%20Ports%20-%20Heparin,Normal%20Saline%20Flush.pdf

Pg 2 has guidelines and concentrations for central lines.

Obviously for information only.

This is a great chart, thanks DolceVita!

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