Our facility is looking at possibly eliminating heparin for flushing our CVAD's and using only saline. We are having trouble finding evidence-based research on this. Does anyone have any research and if your facility is using saline only, can you let me know how it is going? Have you seen an increase in clotted lines?
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
We have been heparin free for over 1.5 yrs. using a positive pressure vale, I have had 25 reported occlusions that I believe to be flushing technique related.
We place an average 140 piccs per month
kevin
Positive displacement needleless connectors are only designed to address the blood reflux caused by disconnection of the tubing or syringe from the connector, but there other causes of reflux. Syringe design, bag running dry and not being immediately disconnected, changes in intrathoracic venous pressure, muscle compression of the catheter are the other primary causes. I know I am beginning to sound like a broken record, but you have to address all of these issues and the entire system. Changing only the type of needleless connector is not the complete answer to occlusion problems.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I can only relay my experience on using positive pressure caps on open ended picc lines. We experienced a slight decrease in clotted picc lines that had been capped with intermitent infusions. Since a positive pressure cap only works its wonder when disconnect occurs. The lines that have run dry, or the lines taken off the pumps in the OR, or if the nurse did not flush after bld draw, left unattened in xray.etc.......we did not find them very effective.
I will say that two years ago we changed product to a valved catheter and our picc occlusions have dropped significantly.