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Heparinizing after lab draw via port?

  • 1.  Heparinizing after lab draw via port?

    Posted 09-08-2019 19:48
    Hi, quick question here, I am still searching for policies regarding heparinizing after lab draws. Do we skip and only saline flush or is it recommended to heparinize after lab draw and after treatment.

    Thank you for your input,
    Lorian

    Sent from my iPhone


  • 2.  RE: Heparinizing after lab draw via port?

    Posted 09-09-2019 08:45
    Hi Lorian,
    In the ONS "Access Device: Standards of Practice for Oncology Nursing" book on pages 70-71, several research articles/ references are cited concluding that no definitive recommendations can be made for flushing volume, solution or frequency and that "evidence has suggested that flushing intervals can approach up to three months without severe complications when flushing with 10 ml NS and 3 ml (100 IU/ml) heparinized saline".   The push-pull  and positive pressure clamping method is also cited as effective after flushing with 10-20 ml of NS  after blood sampling.

    Beyond that, our unit does flush with 10 ml of NS and 5ml of 100 IU/ml heparinized saline after each access, to include if the patient is only having blood drawn.  We are contemplating a change to that policy to reflect current flushing recommendations.

    - Nikki​

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    Nicole Staples MPH BSN
    Nurse Manager
    MetroWest Medical Center-Medical Oncology
    Natick MA
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  • 3.  RE: Heparinizing after lab draw via port?

    Posted 10-10-2019 22:51
    ​Current evidence actually suggests that merely flushing with saline can prevent line clotting. But this is dependent on utilizing effective techniques with this procedure - meaning utilizing pulsatile technique, and engaging the line with negative pressure after flushing (clamping the line - during the last push of saline so that negative pressure created within the walls of the lumen remains in place - before detaching the syringe).
    We heparinize our ports only when it is being de-accessed for pt. discharge or when treatment is completed. We do not heparinize during needle exchange after the 7 day-limit dwell time for our port needles.

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    Florence Okafor MPH, MSN, RN-BC, CPHON
    Professional Development Specialist:
    Adult Oncology; Ambulatory Infusion Center;
    Adolescent & Young Adult Oncology; &
    GYN-Oncology.
    Baylor All Saints Medical Center
    Fort Worth TX
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