Do you use a Heparin free protocol for all your CVADs including port-a-caths and what frequency do you flush your CVADs if you are only using saline?
Melanie Cates
Nursing Practice Leader
Thunder Bay Regional Health Sciences Centre
Do you use a Heparin free protocol for all your CVADs including port-a-caths and what frequency do you flush your CVADs if you are only using saline?
Melanie Cates
Nursing Practice Leader
Thunder Bay Regional Health Sciences Centre
I am a hospital based Home Infusion Specialist. We have been heparin free for years, with only a rare exception. For intermittent infusions we flush with 10ml NaCL before and after each dose in all CVLs. For any unused lumens, or a line maintenance only, we flush with the same volume weekly. (Ports of course we follow the routine maintenance protocal of 10ml saline followed by 5ml heparin monthly when not in use.) With blood draws from any CVL we flush with 20ml NaCl before and after blood draw.
Hope this helps!
Ann Williams RN CRNI
Infusion Specialist
Deaconess Home Infusion
Evansville, IN
Thanks Ann
I would strongly encourage you to closely follow VAD outcomes especially catheter occlusion. There is now 3 studies comparing heparin to saline for CVAD locking showing equiivalent outcomes. I am still not convinced that saline alone is the acceptable solution for CVADs due to the high cost of tPA and/or CVAD replacement. You could follow the quantify of tPA used for clearance to see if this procedure increases. Lynn
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861