We are looking for direction on flushing a cvad immediately after insertion. We do our saline flushes immediately after insertion and before xray confirmation of tip placement, but is it ok to do the heparin flush before x-ray confirmation?
Thank you
There is no research on this specific question but I would weigh the risk vs benefits. I strongly believe that saline alone is NOT sufficient to maintain CVC lumen patency regardless of the type of needleless connector added. I know lots of you are saying I am crazy but those saline only claims are not supported by clinical research. I think the risk of locking with heparinized saline is far less than the risk of locking with saline only and it should be used even before the xray results are known. 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
Agree with Lynn!!!!! Now the question is volume and strength you are flushing with compaired to the prime volume of your catheter. If your prime volume is less than 1ml and you are flushing with 5ml heparin....we might have a problem.
Are there not studies that have compared outcomes between heparinized PICCs and "saline-ized" PICCs, and the clotting rate is the same? If there is no increase in clotting of saline-flushed PICCs, why wouldn't we go with the cheaper, less risky (HIT), option of saline?
Wendy Erickson RN
Eau Claire WI
There is one study, that I remember , on locking PICCs with saline vs heparin lock in home care. See lists of references in Flushing and Locking Standards from INS 2016. 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