NICU Heparin Flushes

Please note that many IV medications are incompatible with heparin so it is important to flush before and after IV medication administration with an appropriate flush solution.

PICC LINES

If the PICC is hep-locked, flush with 0.5ml heparinized saline (10u/ml) every 4 to 6 hours and after accessing the port for meds (Flush 0.5mL of NS—or appropriate flush--before and after the med to prevent precipitation from incompatibilities with heparin.)  Use at least a 10mL size syringe to flush with NS as it exerts less pressure than a 3 mL syringe.

Alternatively, the physician may order a KVO of heparinized saline.  In this situation, the line does not require additional heparin flush, however, the administration of a med still needs to coincide with a NS (or approapriate flush) before and after medication administration with use of a 10mL syringe.

BROVIAC® CATHETER LINES

If intermittent use (heplock), flush with 0.5ml heparinzed saline (10u/ml) at least every 24 hours and after accessing the port for meds, etc.

UAC/UVC LINES

INSERTION—In an effort to further promote safety around heparin usage in the NICU, all umbilical lines will be placed with NS instead of heparinized saline.  If the new IV fluids are not at the bedside at the time of insertion, the nurse will administer 0.5 mL of premixed heparinized saline (10u/mL) via the newly inserted umbilical line.

HEPLOCK—For intermittent use of one port (usually the smallest port), flush with 0.5ml heparinized saline (10u/ml) every 4 - 6 hours and after accessing the port. Positive pressure should continue on syringe until stopcock is turned off. This keeps blood from advancing into the catheter tip. (It is very rare in our unit that a UVC/UAC would have a hep-locked port.)

LINE FLUSH—For routine flushes after lab draws use plain normal saline without heparin.  Since the infusing fluids contain a ¼ unit/mL of heparin, it is not necessary for flushes. 

Updated May 7, 2009