I am a recent LPN grad and I just recently began working in an out patient oncology office. Today, I came across a patient who had just been discharged from the hospital and came over to out clinic to receive hydration. The patients wife was a nurse, and informed me the patients port had been heparinized at the hospital and that I must withdraw the heparin from the port before continuing with the flush, blood draw, and hydration. I was taught just briefly in school about ports and was under the impression that I only needed to flush the port with saline. I asked 2 of the RN's I work with and they gave conflicting answers;one became irritated that I asked, and ended up accessing the port herself. So now I am thoroughly confused as to the correct method of working with heparinized ports. Any clairification or tips would be greatly appreciated!
We insert 5000u/5ml heparin into our infusaports when deaccessing and as such always withdraw at least 5-7ml on accessing
Dang, that's scary... Why use such high concentrations into an implanted port? The standards state to always use the lowest concentration, which for ports, should be 100 units per ml, not 1000.
Specializes in Oncology, ID, Hepatology, Occy Health.
What brand of ports do your pt's have? Most of our ports are a Groshong tip caths so only saline is needed. Correct me if i'm wrong.
Agree. I thought heparinising ports died with The Freak.
Over the years I've worked with Hickmans, Groshongs, standard CVCs and where I work now it's nearly all Portacath.
20cc saline flush is sufficient.
I remember heparinising going out of fashion when I was in the UK in the late 1980s. Sure it was all research based, and the heparinising of such lines just isn't necessary.
Per ONS standards, 10cc of blood should be withdrawn from Port and discarded prior to drawing blood. When accessing a Port for treatment or fluids always check for a blood return, but blood does not need to be discarded.
So now I am thoroughly confused as to the correct method of working with heparinized ports. Any clairification or tips would be greatly appreciated!
IVRUS, BSN, RN
1,049 Posts
Dang, that's scary... Why use such high concentrations into an implanted port? The standards state to always use the lowest concentration, which for ports, should be 100 units per ml, not 1000.