Also, don't forget the issue added by syringe-induced reflux. A
traditional syringe will cause reflux due to compression of the
rubber gasket at the end of the plunger rod. When you release this
pressure, the gasket expands and pulls blood into the lumen. So
another technique that should be taught is to not completely empty
the syringe to avoid this compression. Or change to a prefilled
syringe designed to overcome this issue. There are 2 brands
available, one from BD and one from Tyco Kendall. Lynn
At 6:38 PM -0700 9/30/06, Nadine Nakazawa wrote:
We've been trying to do NS flush/locks on all CVCs & PICCs using the
MaxPlus since May '06. We've had mixed results, although recently
I've been hearing about fewer complaints. We may move back to
heparin for the outpatient population since declotting in the home
setting is a lot more problematic.
We moved to 20 mls NS flushes after lab draws.
A struggle to get "consistency of care across the continuum of
care". We dont' have much control over how and when nurses flush,
disconnect the flush syringe and THEN clamp the PowerpICCs.
They've been inserviced as to this technique with posters
everywhere, but I think inconsistent practice is still causing
clotting.
Nadine Nakazawa
From: "Nauman, Tanya" <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED]
CC: "Perry, Stephen" <[EMAIL PROTECTED]>
Subject: Saline only flushes for central catheters
Date: Fri, 29 Sep 2006 12:51:33 -0700
We are trialing PowerPICCs right now and several physicians have
approached me with their concern over the heparin flush required
by our flush policy for open-ended central catheters[10ml NaCl
and 2ml Heparin(100 units/ml) Q 8hrs when not in use and after
blood draws]. They would like us to change to Saline only flushes.
Have any of your hospitals or services gone to saline only flushing?
Do you know of any articles supporting this practice. I found one on
PubMed from Transfus. Sci June 1997...but that's it.
I reviewed the postings in the archives--just would like to get an
idea of how many hospitals are actually heparin-free as far as
Central line flushing.
We are using the MaxPlus cap. I've heard of a "neutral" pressure
cap, anyone using those?
Thanks so much
Tanya
I.V. Support
SHMC
Eugene, OR
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