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Kathleen M. Wilson
Heparin prefilled syringes

We only have prefilled heparin syringes  stocked in 5 cc syringes. This is obviously not facilitating people using a 10cc syringe for port flushing. Has anyone else run across this problem? Do you have any difficulty getting the Heparin with 3cc or 5 cc in a 10cc syringe?

 

Thanks, Kathleen

lynncrni
It is available in a 10 mL

It is available in a 10 mL syringe. However, once you have assessed patency with a 10 mL saline filled syringe, you should be able to use a 5 mL syringe with a 5 mL fill volume for the heparin. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Kathleen M. Wilson
Lynn, I just want to clarify.

Lynn, I just want to clarify. Are you saying that a 5cc syringe can be used on a port? Thanks, Kathleen

Kathleen Wilson, CRNI

lynncrni
Here is what I am saying: 1.

Here is what I am saying:

1. that smaller syringes create greater amount of pressure coming out of the male luer end of the syringe tip on injection. With aspiration, the opposite is true - smaller syringes create less pressure.

2. fluid must flow by a pressure gradient. The external pressure must be greater than the internal pressure in order for fluid to flow.

3. the pressure gradient is created by a pump, by gravity flow from a container above the patient, and by manually pushing a syringe plunger.

4. Gravity flow is ~2 psi, pumps vary by brand but we have no way to know what amount of pressure we are generating from a syringe.

5. The concern about syringe size is its relationship to creating intraluminal pressure in the catheter, so high that the catheter could rupture. This will always occur in a linear slit along the cathter length, not a circumferential split of the catheter.

6. Syringe is ionly one factor in the whole equation of intraluminal pressure. But there are many others including the size of the caregivers hand and the strength in that hand, the diameter of any tubing between the syringe and catheter, etc.

7. For intraluminal pressure to reach a level high enough to damage a catheter, there must be 2 factors - the amount of force applied to the fluid flow is meeting resistance somewhere along the fluid pathway. This could be from a kinked tubing or catheter, clogged filter, closed clamp, intralumin occlusion from a thrombus, or something inside the vein at the tip of the catheter like a thrombus or venous valve for a peripheral catheter. If this occurs, one must always stop and investigate what is causing this resistance. Never, ever, under any circumstances forcefully flush any catheter against this resistance for any reason whatsoever!!

8. If you have properly assessed the catheter functionality with a 10 mL syringe and found a great blood return and no resistance to your manual flush, no signs and symptoms of a complication, no complaints of anything from the patient, then you have established that the catheter is open and patent. After this assessment with a 10 mL syringe, you can and should use a syringe size that is most appropriate for the drug or solution being given. Syringe to syringe drug transfers are dangerous and should be stopped. A 5 mL or even a 3 mL syringe can be used after you have established line patency.

9. No minimum or maximum syringe size is included in the INS standards of practice, never has been.

Hope this helps, Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Kathleen M. Wilson
Thanks, Lynn!!

Thanks, Lynn!!

Kathleen Wilson, CRNI

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