My facility is ready to go heparin free. I now have a critical care doc who wants to go heparin free in ALL lines.  We use all open ended catheters, so I already have in place a positive pressure cap (Maxplus) and prefilled saline syringes (Kendall). I have read where other facilities have had an increase in clotting incidents after the switch, so I would like to do an informal survey of current practice.
1. How often are you flushing triple lumen and PICC lines? q12 or q8?
2. What volume of saline are you flushing with?
3.  What do you do with tunneled (open-ended) lines and ports?
4.  What do you do with arterial, PA, and CVP lines?
Sarah
Kathy Kokotis
Bard Access Systems
Since this is a new science there are no answers or studies to refer you to. I suggest 10 cc flush of saline unless the solution is viscous or highly incompatible and than suggest 20 cc saline (blood, dilantin, nutrition). Strictly anecdotal
How often. There is no answer. Every 12 works good? But how often in a hospitalizaed patient not getting drugs? Is is the outpatient that really gets few drugs. In-patients lines are usually in use and flushed anyway or have continuious solutions.
Do not expect to elminate clotting. You will still get clotting. Fibrin sheaths, tails, mural thrombosis will still occur.
Kathy Kokotis
Bard Access Systems