Flushing a CVC (Central Venous Catheter) line with heparin involves carefully and slowly injecting the heparin solution to prevent blood clots from forming in the catheter. Here's how it's generally done:
Important Safety Note: These instructions are general guidelines and should NOT replace specific training or protocols provided by your healthcare provider. Always follow your facility's policies and procedures.
Steps for Flushing a CVC Line with Heparin:
-
Gather Supplies:
- Heparin flush solution (pre-filled syringe with the correct concentration as prescribed by your doctor or facility policy)
- Alcohol swabs
- Gloves (non-sterile)
- Gauze pad
-
Prepare the Heparin Syringe:
- Confirm the heparin concentration and volume with the physician's order and the label on the syringe.
- Check the syringe for any particulate matter or discoloration.
- Remove the syringe cap, maintaining sterility of the syringe tip.
-
Prepare the CVC Line:
- Wash your hands thoroughly and put on gloves.
- Clean the catheter hub with an alcohol swab for at least 15 seconds. Allow it to air dry completely. This is crucial to prevent infection.
-
Attach the Syringe:
- Attach the heparin syringe to the catheter hub using a Luer lock connection, if applicable. Make sure it is securely connected.
-
Flush Slowly and Deliberately:
- Slowly inject the heparin solution into the catheter. Do not force it. If you meet resistance, stop and troubleshoot (check for kinks, clots, or other obstructions).
- Use a pulsatile flushing technique (push-pause) to help clear the line effectively. Inject a small amount, pause, inject another small amount, pause, and so on.
-
Positive Pressure Technique:
- As you are injecting the last 0.2-0.5 mL of heparin, clamp the catheter (if applicable to your CVC type) to maintain positive pressure within the catheter. This helps prevent blood from flowing back into the catheter lumen and forming clots. Remove the syringe.
-
Dispose of Supplies:
- Discard the syringe in an appropriate sharps container.
- Remove gloves and wash your hands thoroughly.
Important Considerations:
- Concentration: The concentration of heparin used for flushing is typically much lower than the concentration used for therapeutic anticoagulation. Ensure you are using the correct concentration as prescribed. Common concentrations include 10 units/mL or 100 units/mL.
- Volume: The volume of heparin flush will depend on the type and size of the CVC. Check your facility’s policy or the manufacturer's instructions.
- Frequency: The frequency of heparin flushes depends on the type of CVC, how frequently it's used, and your facility's protocol. Some lines require flushing only after use, while others need regular flushing (e.g., daily or weekly).
- Troubleshooting Resistance: If you encounter resistance while flushing, do not force it. Try repositioning the patient, checking for kinks in the tubing, or consulting with a healthcare professional. Forcing the flush can damage the catheter or dislodge a clot.
- Sterile Technique: Always maintain a sterile technique when accessing the CVC to minimize the risk of infection.
