Forum topic

8 posts / 0 new
Last post
Pam Michael
Implanted ports

A question for anyone dealing with implanted ports.

If you have an inpatient who does not have a continuous IV running, but has prn meds, or scheduled antibiotics, what is your policy for flushing? Do you flush with saline ONLY before and after meds, or do you also use heparin. I am questioned almost weekly about this, even though our policy is for saline only unless you are 'locking off' the patient. When we lock off we use 500 units heparin, then the needle is removed and the patient is discharged home.

Please let me know what others are doing.

Pam Michael, RN

lynncrni
What type of needleless
What type of needleless connection device do you have on the end of the port access needle? If its instructions state saline only flushes, then you do not have to use heparin. Lynn

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

Pam Michael
We use CLC 2000's. Pam

We use CLC 2000's.

Pam Michael, RN

Pam Michael, RN

lynncrni
Then you can place a CLC2000
Then you can place a CLC2000 on the end of the port access needle and flush with saline only while the port is accessed. Lynn

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
Question re: 10u/ml vs.

Question re: 10u/ml vs. 100u/ml for heparin flush in implanted ports - is there evidence to show that we should use 100u/ml instead of 10u/ml in implanted ports?  I know the INS sop say 100u/ml for implanted ports, but evidence would be helpful. 

Currently our policy states to flush non-valved CVADs with 10u/ml heparin flush, except for implanted ports (unless you know they're valved - big question sometimes until we get our EHR operational) which are flushed with 100u/ml heparin flush.

Our pharmacy would like to reduce/eliminate 100u/ml heparin concentration because of the potential for error - whether in pre-filled syringes or not.  We'd like to flush non-valved implanted ports with 10u/ml heparin, unless evidence shows that we'd have occluded ports. 

Finally - all of this may be a moot point, because we're soon to be finished with our needleless connector standardization to neutral or positive, and will be potentially flushing all CVADs with saline only except when ordered by MD to be flushed with heparin flush (NICU/PICU MDs prefer to use heparin on the 2-3 Fr catheters.)  In the meantime, evidence and discussion about this would be helpful.

 

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 just finished the

I just finished the exhaustive literature searches for the 3 INS webinars on catheter flushing. There are extensive reference lists for all 3. Check those lists, but I do not recall a specific study looking at the heparin concentration on implanted ports. There was one study that assessed the patency of implanted ports with a variety of intervals between being accessed.  

 

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
I'll check it out again - I

I'll check it out again - I did look at that list a month or so ago, but couldn't find the one specifically about heparin flushes in ports.  I'll look again. 

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

KATHLEENT.MOHN
kathy mohn-las vegas If you

kathy mohn-las vegas

If you know which manufactured port the patient has implanted-what does the manufacturer   say about flushing their device???

kathy mohn-las vegas

Log in or register to post comments