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Thu, 07/26/2007 - 13:47

tamster

questions

We have a very old p/p for management of implanted venous access catheters that I need to update.Â We currently are flushing after each use with 20cc NS and 5cc of 100u/;cc heparin saline.Â It is recommended that they be kept open with a running IV at tko to avoid the heparin.Â This is the question that was brought to me:

If a patient has CHF and is getting ABX q 4 hours or even q 6 hours, will he be getting too much heparin if we flush and cap off after each use?Â But, if we keep the IV at tko, will he be getting too much fluid?

Also, is there any good evidence based research out there regarding waste for blood draws?Â We currently draw off and waste 10cc but I think this is too much and 5cc should be sufficient.Â Thank you.

Thu, 07/26/2007 - 14:37

jadahl

I am wondering how often you

I am wondering how often you are flushing your outpatient Power PICCs when you are using a positive pressure valve? Are you using Heparin or just saline? THank you.....Jane Dahl Salem hospital, Salem OR

jane dahl, crni

Thu, 07/26/2007 - 18:53

lynncrni

There is no such thing as a

There is no such thing as a magic rate that will keep any catheter open. And a KVO order is not a legal order because it does not specific a rate for that patient. I do not believe that keeping patients tied to any fluid when there is not clear therapeutic indication is not in the patient's best interest. Your policy for flushing ports can be 5 to 10 mL saline before and after each use followed by 3-5 mL of 10, yes I mean ten, units of heparin after each use. If using a Groshong or PASV port, the heparin is not necessary. When the port is de-accessed flush with 5 mL of 100 units per mL 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

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