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Heparin flushes with Power PICCs?
The DFA for Power PICCs state that they should be flushed with heparin flush after use.   We've also been told that a positive or neutral displacement cap eliminates, or greatly reduces the need for heparin flushes for Power PICCs.  We are trying to get away from heparin flushes (d/t HIT).  Please share what you know about heparin flushes and Power PICCs.  Thank you,Mari
This always causes confusion
This always causes confusion - catheter instructions state one thing but the needleless connecter has the opposite. The PowerPICC manufacturer must state to use heparin because that catheter does not have any type of valve built into it. When you use a brand of needleless connector that has instructions for saline-only flushing, you can use saline only on any catheter including a PowerPICC. The catheter manufacturer's instructions must be based on the features of the catheter alone but adding the saline only needleless connector means you can follow the saline only recommendations for that specific needleless device. It is also important to remember that lumen occlusion from blood reflux is dependent upon numerous other components including syringe design and flushing technique. So may sure you are managing the entire system. Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Thank you, Lynn - that was
Thank you, Lynn - that was very helpful.

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

Even with the positive

Even with the positive displacement caps, we're getting plugged Power PICCs.  I'm assuming that part of this is incorrect flushing/clamping tecnnique, and we're doing as much education reinforcement as possible.  This may take a while to adjust.

In the meantime, what difference does syringe design make?  We use either 12ml Kendall monoject luer lock, or 10ml 0.9% NaCl prefilled monoject Advanced (doesn't state luer lock, but appears to be).

Mari Cordes 


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

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