I have a few questions regarding Hemo/dialysis catheters.
We as a Vascular Access Team may be taking over management of these lines post dialysis. We have been asked to ask the forum.....
1. When pediatric acute hemo/dialysis catheters are post dialysis and need flushed what flushing
...what flushing technique/strength is used?
2. What extent if any does the vascular access team care for thesees lines?
Thank you,
Ellen Snell, RN
RN, BSN, VA-BC
Children's Mercy Hopital
KC, MO
Hi All,
I want to first apologize for reposting this. I had tried before but was in a hurry and hit send before I was done typing.
The Vascular Access Team that I am a part of may be taking over management of hemo/dialysis catheters post dialysis. I have been asked to ask the forum.....
1. When pediatric acute hemo/dialysis catheters are post dialysis and need flushed how often are they flushed and with what strength of heparin?
2. To what extent does the Vascular Access Team at your facility care for hemo/dialysis catheters if at all?
If you are on a VAT and do not care for hemo/dialysis catheters please comment just to let us know.
Thank you,
Ellen D. Snell, RN, BSN, VA-BC
Vascular Access Team staff
Manager:Leslie Jakobe
Children's Mercy Hospital & Clinics
Kansas City, MO 64108
816-234-3930
RN, BSN, VA-BC
Children's Mercy Hopital
KC, MO
I am ona VAT at a pediatric facility and we do not care for the dialysis catheters. They are completely under the domain of the dialysis staff.
As an infusion nurse on an infusion team for about 20 years in 4 hospitals in the Atlanta area, I have never cared for a hemodialysis catheter. But I can easily see where this would be interventions designated to an infusion or VA team. INS Standards have sections about these catheters and there is the K-DOQI Guidelines from the National Kidney Foundation.
Are you asking about flushing these catheters or locking these catheters? Flushing is done with saline in the same manner as any other CVAD. The quantity may be more because of the larger lumen size. For locking, the INS Standard on locking follows the recommendation from the American Society of Diagnostic and Interventional Nephrologists, which recommends heparin 1000 units per mL after each use. For peds, they did not provide a separate locking concentration. For children, this amount of lock solution could be aspirated from the lumen rather than being flushed into the bloodstream. Some of the peds infusion/VA nurses on this list might be able to provide a better response.
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
In our facililty, hemodialysis catheters are cared for solely by the dialysis staff. They are RARELY used for IV access if no other access is available.
I used to assist with insertion, flushing was with NS and then the catheter was "locked" with a priming volume of 1000unit per ml Heparin.
Keely Ralston RN-BC, VA-BC, CPUI, RCIS