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mary ann ferrannini
Normal Saline only flush frequency and flush frequency on Hemodialysis catheters

I am revising our CVC protocol and would like to add a Normal Saline Flush for HIT + patients. I would like it to be either 1o ml NS q 12 hours or NS q 8 hours and 20 ml after a blood draw. This will be done in a pulsatile start stop technique. This will cover all types of CVCs. Yes we still use a very low dose Heparin as a final flush. My second question is on tunneled and non-tunneled Dialysis catheters. What are others doing. Are they just letting them be flushed 2-3 times weekly after Dialysis and of course prn use. We do not allow their use for routine IV therapy without special permission. Our old protcol was q 12 hours and no one would follow it. What is everyone else doing. I know all the INS quidelines mostly interested in your actual policies on these two issues. Thank you in advance for your responses! It is appreciated.


In a patient that is

In a patient that is diagnosed with HIT, I would never use any dose of heparin lock solution regardless of how what that concentration actually is. In these patients, all heparin must be totally stopped. In those patients, there are several studies that have looked at other solutions, such as alteplase, lepirudin, plus numerous others. You can find more information about this in my literature review on the INS website. This was included in the series of 3 webinars on catheter patency. This information is in the 3rd one with a complete list of references. I would only allow dialysis nurses to do any thing with dialysis catheters including flushing them.  


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

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

mary ann ferrannini
Thank you Lynn. We are not
Thank you Lynn. We are not looking to flush HIT + patients with any Heparin,as a matter of fact we even stop it pending lab results to verify it. We are using just the NS at this time for the HIT + patients. I was thinking the same thing for the Dialysis catheters unless we need to use it urgently. Tx for all the info!!!!!!  Mary
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