please help! :)

[sweetieann]

Kind of a simple question....

I'm wondering about daily and intermittent flushes of Heparin. If someone is heplocked, and receiving meds through the lock, I know you'd flush before and after you admin. the med (10 U/heparin)...my question is: do you also have to do a "daily flush" (100 U/ml), or do you only do the 100 U/ml daily flush if they are NOT receiving anything thru the lock?

thanks!!!

[JaneyW]

We use heparin flushes on our pregnant and postpartum patients because they are hypercoaguable, but I don't think they are used in general population any more. Isn't the standard of care saline flush? We do flushes with meds and 10 units q 8hrs for maintenance.

[Inquisitive one]

Our pharmacy's policy is to flush the heplock with 1 ml heparin 10 units/ml every 12 hours when not in use. Heparin 100units/ml is only used for midline, piccs and central lines. Heplock sash is normal saline 3ml premed, med, normal saline 3 ml after med followed by heparin 1ml 10 units/ml.

[JennaRN1006]

We use heparin flushes on our pregnant and postpartum patients because they are hypercoaguable, but I don't think they are used in general population any more. Isn't the standard of care saline flush? We do flushes with meds and 10 units q 8hrs for maintenance.

I was thinking the same thing. I am on an onc. unit and if our pts are heplocked, q shift we flush with 3cc of NS to make sure the line is patent. When we hang meds, again flush with NS only. We only use Heparin for PICC lines, Mediports, etc.

[Xbox Live Addict]

In OK, heparin locks are still widely used and heparin is used to keep them patent. Only at the OU Medical Center have I seen saline lock flushes used.

[CarVsTree]

We no longer use heparin flushes for peripheral IV's, PICC's, or TLC's and have not for some time. The overuse of heparin can cause problems for some patients and has been phased out.

Our PICC's are Passive PICC's and are designed to be flushed with NSS only. Have never seen a true heplock even in nursing school. Although I'm still prett new to nursing. STarted school in Jan '04 and graduated in Dec 05'.

[Xbox Live Addict]

We no longer use heparin flushes for peripheral IV's, PICC's, or TLC's and have not for some time. The overuse of heparin can cause problems for some patients and has been phased out.

Our PICC's are Passive PICC's and are designed to be flushed with NSS only. Have never seen a true heplock even in nursing school. Although I'm still prett new to nursing. STarted school in Jan '04 and graduated in Dec 05'.

Well, I'm all for saline locks myself. NS is, after all, the safest substance to tissues and I imagine there's quite a few people out there who are allergic to heparin or have other issues causing compromise in their coagulation. But other than a few weeks of clinicals at OU, every other place I've been, hospitals, NHs, you name it, have used the old SASH protocol (Saline, Administer meds, Saline, and Heparin), even on a cheap peripheral line not designed to last more than 2-3 days if you're lucky. On a long-term access such as a PICC, the saline and heparin are still used to keep it open when the patient is not getting meds or fluids, until the physician decides what he wants to do next.

[classicdame, MSN, EdD]

Are you talking about a peripheral IV or PICC or other central line?

[colleennurse, ASN, RN]

I think that the only type of access my facility that uses heparin flush is for quinton caths. Other than that it is all NS for peripherals, PICCs, and Central lines. We have special caps for our PICCS that make it so you no longer need the heparin flush.

[P_RN, ADN, RN]

We stopped using routine heparin lock flush about 10-12 years ago. Unless there is a medical reason (like increased coagul.) saline is all I've seen. Saline/abx/saline SAS