I am looking to revamp our flush protocols. Â Presently we flush Â open central lines with 5ml NS before and after medication and daily if dormant followed by 5ml (10unit) heparin. Â Groshongs are 5ml NS before and after medication and weekly if dormant. Â I would like to change to Â 10ml NS instead of 5ml. Â Does anyone see any problems with this?
Also, we supply 10unit heparin but quite often our HH agency has to work with an outside infusion company and they often use 100 unit. Â Is there any information what is the best amount to flush with? Â I have found everything from 1-5ml of 100units. Â The INS standards states the flush amount should be equal to at least twice the amount of the catheter. It also states that heparin should be the lowest concentration possible to maintain patency. Â I would like to include a 100unit amount in our protocol, but we will continue presently to supply and use the 10unit from our pharmacy. Â I probably just answered my own question but I would like to know what others are doing?
One other thing, recently there was conversation regarding the caps/valves with TPN. Â The CDC states the 'tubing' should be changed with each bag (every 24 hours) but what about the Â valve (we use the CLC 2000 positive pressure valve). Â Should this also be changed? Â Is this necessary when the infusions are continuous, should we connect without any device? Â
Is there any documentation regarding any of these, other than what I mentioned from the CDC and INS? Â These are the two I primarily go by but I would like something to help me get more specific with my changes.
Thank you once again,
Patti Atteberry, RN, CRNI
OSF Home Infusion Pharmacy