UAC fluid/antiseptic

[dbscandy]

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

[Sweeper933]

Our docs use betadine / alcohol before insertion

For babies >1000g, our standard is to run NS at 1ml/hr w/ 1 unit of heparin per ml

For babies

[NicuGal, MSN, RN]

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.

[elizabells, BSN, RN]

Betadine for everyone.

Term kids get NS 1unit:1ml heparin, run at 1.2ml/hr

Preterm get D5W 1:1 with hep, also at 1.2ml/hr.

[Mimi2RN, ASN, RN]

Betadine for us, too.

We use 0.45 NS 1:1 with 1/2 unit of heparin at 1ml/hr. On the kids less than about 800gm we run 1/4 ns with 1/2 unit of heparin at 0.5 ml/hr.

[texas2007, BSN, RN]

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.

[dbscandy]

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...

[BittyBabyGrower, MSN, RN]

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.

[SteveNNP, MSN, NP]

In my last unit, we used chloraprep for all gestational ages, and for all line insertions (PALs, UA/UVCs, PICC, PIVs) and for all blood cultures and venipunctures. We never had any burns. We did use the lower concentration though... our infection rate was quite low as well.

[elizabells, BSN, RN]

We're about to start trialling Chloraprep for all PICC insertions, regardless of gestational age. Still use alcohol wipes for PIVs, venipunctures, art sticks, etc. Oh, but we use Chloraprep for peripheral blood cultures, IIRC.

[preemieRNkate, RN]

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.

[Sweden]

We use a mix with Vaminolac and water in all our arteriall lines, umbilical or peripherial. Heparin is never used in my unit.

Umbilical lines are cleaned wih NS for a baby under 30 weeks, for all others it´s chlorhexadine.

Anna