port clot questions

IVRUS, BSN, RN · Mar 30, 2011

i am a newer hem/onc nurse and have questions about heplocking a port a cath. How long does it take for a port to clot off without heplock? Hickman? How do you de clot a port? What concentration of heplock do you use in infants?
often times we do not heplock kids if they go for an infusion the same day. Could the port clot off in hours? days? without heplock? what tips can you give for ports and keeping ports from clotting? thank you!

First and foremost, you MUST follow your employing facilities policies. All of these questions should be addressed with your employer and utilizing their P&P manual.

But, in general:

Always use the lowest concentration possible for "locking" an IV catheter. !0 unit per ml is appropriate, except for implanted ports. Ports normaly get flushed with 100 unit/ml heparin flush. Heparin is used as the final "locking" solution to prevent fibrin accumulation at the catheter's end. Hep flush WILL not clear an occlusion, however. You would need a fibrinolytic agent like Cathflo if the IV catheter is occluded.

How quickly does a catheter occlude? Well, that question begs others:

1. Does the patient have hypercoagulability issues?

2. Was the IV catheter "locked" for awhile and hadn't been flushed?

3. Did the infusion get interrupted and then clot?

Bottom Line, follow agencies policies and flush with the right solution, in the right way, at the right time... ALWAYS.