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gsbrn
10ml vs 100ml Heparin Flushes

We are thinking about changing to a 10:1 heparin flush for all central lines (except ports) from the 100:1 heparin flushs we currently use.  I've been looking for supportive data, but have been unsuccessful.  Does anyone have any reference material that would support changing from 100:1 heparin to 10:1 heaprin?

 

Greg Bowman, RN

Clinical Supervisor, IVT

Swedish Medical Center

lynncrni
 Here is one that was used

 Here is one that was used to establish the new recommendations for 10 units per mL for the INS Flushing Protocol cards:

1.    Buswell L, Beyea S. Flushing protocols for tunneled central venous catheters: An integrative review of the literature. The Online Journal of Knowledge Synthesis for Nursing. 1998;5(3).

This article reviewed 6 studies and strongly recommended that tunneled catheters be flushed with 10 units per mL.  

 

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

momdogz
Lynn:  I'm still not having

Lynn:  I'm still not having much luck identifying which study in your reference list that supports using 100u/ml for ports...the brazilian study with rabbits is in r/t saline vs. heparin.  Any other helps?  We'd like to standardize to 10u/ml for all non-valved devices, but don't have evidence yet either for or against.

anyone else have comments/suggestions?

 

Thanks in advance,

Mari 

 

 

Mari Cordes, BS RN 

Nurse Educator IV Therapy
Fletcher Allen Health Care, Burlington VT
Educator, Bard Access Systems 

Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

lynncrni
I don't think you will find

I don't think you will find a study specific to implanted ports and the concentration of heparin. This is the only study I have ever seen about flushing implanted ports:

Kuo Y, Schwartz B, Santiago J, Anderson P. How often should a Port-A-Cath be flushed? Cancer Investigations. 2005;23:582-585. 

This is one of those questions where there is no published studies, so we must rely on expert opinion such as the new flushing protocols from INS. This is a form of evidence, although it is lowest on the hierarchy.  

 

 

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

momdogz
Thanks, Lynn. Mari Cordes,

Thanks, Lynn.

Mari Cordes, BS RN 

Nurse Educator IV Therapy
Fletcher Allen Health Care, Burlington VT
Educator, Bard Access Systems 

Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

coffeemania
Did anybody ever find out
Did anybody ever find out how much heparin is needed to lock an implanted port? Thanks in advance for any info.
lynncrni
Order the Flushing Protocol

Order the Flushing Protocol Cards from INS. They contain all the needed info about different types of catheters, different therapies, and ages. Locking an implanted port is the only time that 100 units per mL of heparin is recommended. 

 

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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