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We use chlorprep and then sterile water to clean off after insertion.
All kids get half normal saline with half unit of heparin per ml. On the micronates, we use half ns with one quarter unit of heparin per ml. And no, our lines don't clot off. All are run at half ml per our unless they are big full termers then they go at one ml per hour.
In kids >28 wks, we use Chloraprep. I'm not sure what we use in kids under 28 weeks, I had heard NO CHLORAPREP for that age group but have seen some nasty burns on kids that age as well so I'm not sure where the error happened.
Every kid with an art line gets .45 NS with .25 unit Heparin at 0.5 ml/hr.
Thanks for everyone's input; the different mixes for the arterial lines is interesting, and the information is appreciated. We're looking to reduce our heparin usage as most other units are, also.
One main point I am interested in is the use of Betadine vs Chloroprep; I have also seen some nasty burns and think it does not belong in the NICU. IMHO, a minute exposure to iodine certainly outweighs the liability of the off-label use of this chemical...
Actually, if the people placing the lines wipe down the area with sali-wipes or sterile water after insertion, you won't get the burns. We have been using chloroprep for about 2 years now on all gestations and haven't had a problem.
We use 1/2 NS with 1/4 unit heparin/ml on all lines, usually at 0.5ml/hr.
We use NaAcetate (Full, 1/2 and 1/4) or NS (Full, 1/2 or 1/4). Both with 0.5 units of heparin/mL. We usually run at 1 mL/hr, sometimes 0.5 mL/hr on the smaller babies. We change fluids based on lab results daily (or sometimes more). Umbilical lines are placed with betadine prep. We do use Chloraprep for PICCs, Broviac dressing changes and art sticks.
dbscandy
116 Posts
As an informal survey, what is the standard UAC fluid used, and rate, for your unit? Does it depend on the gestational age/weight of the infant?
Also, which antiseptic is used prior to insertion?
Thanks