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Kim Springer
Saline Flush only CVAD's
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?
lynncrni
There have been very few
There have been very few clinical studies published on using saline only for central venous catheters. Check the manufacturers instructions for use for the valved catheter or needleless connector. Not much other evidence available. Lynn

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

rivka livni
In october we switched to NS
In october we switched to NS flush only using positive pressure caps, it took a bit of education, but so far it has been great, no occlusions since October 1, 2007. By the way we use it on all IV, PIV, CVD, PICC.
Kevin Travis Flint
We have been heparin free

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

lynncrni
Positive displacement

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., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Donna
I can only relay my

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.       

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