Has anyone heard of RNs being taught to ALWAYS aspirate the heplok solution from a port before using it for administration of fluids or medication? The only line I recall being taught to aspirate the heparin in the line prior to use was many years ago when the patient had a temporary jugular large volume double lumen dialysis catheter in place and they had used high strength Heparin 10,000U/ml to lock. This was many years ago, and it was a very unusual circumstance. We were not using the dialysis catheter for home infusion therapy. Yesterday I had a phone conversation with an RN in Home Infusion that insisted she had been taught that it was always necessary to aspirate the heparin solution in the port prior to each use. Looking for feedback. Thank you.
Hemodialysis catheters using a large dose of heparin is what has driven this misconception. Aspiration ONLY applies to these HD catheters and not to any type of catheter used for infusion. For locking an implanted port when it is de-accessed INS resources recommend 100 units per mL of heparin lock solution. To lock you might need 3 to 5 mLs depending on the size of the port body and catheter length. When the implanted port is accessed and used intermittently, it is locked with 10 units per mL of heparin lock solution. So 300 to 500 units may be used to lock a port at the time it is deaccessed and 30 to 50 units when used intermittently. As you can see these doses would not reach a therapeutic level, but the large doses of heparin could result in 3000 to 5000 units being given as a bolus. 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
Thanks Lynn. That was my thought too. I've been in Home Infusion for 35 years, and this was a first!
Hallene E Utter, RN, BSN Intravenous Care, INC