Shari

At our institution we have standing orders for morphine 2-5 mg or Valium 5-10mg for sheath pulls. After we draw ACT levels we do not flush the line unless it is connected to a fast flush device with pressure bag. Sometimes our patients come back with lines in that are capped off in anticipation for quick removal. The theory behind not flushing after drawing is to prevent the flushing in of any clot formation at the tip of the sheath. I don't have any research info. readily available at this time.

We pull femoral sheaths where I work. The policy varies as far as the way in which you pull the line. Manual, Compressar, and Femostops are what we use. On our standing orders there are paramaters that have to be met in order to pull the lines. First anti-coagulants must be off. The ACT must be less than 170 seconds. The SBP must be less than 150mmHg. The patient must be pain free and adequately sedated as necessary. If you need more info on line pulls don't hesitate to ask!