PICC lines with Heparin

When using a PICC line that is heparin locked, do you pull off the heparin before using it?
In my experience, usually the PICC is flushed with NS prior to use to clear the heparin. In most cases, unless the PICC has a lumen that is designed for blood sampling, they are too narrow to aspirate without collapsing.

If Heparin is used, you should pull off the heparin. The PICC lines that I used at our facility did not use Heparin. It was actually discouraged with the brand that we used. Maybe you have a policy or procedure at your facility that you can check. Also, check with manufacturer's brochure to see if Heparin should be used. Hope that helps.Christy

We pull it off before each use.. After the use of one of the ports; heparin was put back in to prevent it from clotting off.. Q12 hours all the ports had to be done.. We had to remove the heparin, flush with NS and then add new heparin..

We no longer use heparin on our PICCs. Prior to that we would flush with NS, instill meds, flush with NS and then follow with 1ml heparinized saline.Sounds like a policy check with your educator or manager would be the best route to go here.

Quote from manguaWhen using a PICC line that is heparin locked, do you pull off the heparin before using it?

Quote from IVRUS Using this concentration, or even the 100unit per ml, WILL NOT cause issues with flushing, and therefore need not be drawn off prior to saline flush.

But HIT is not concentration dependant. Drawing it off makes little sense in the respect that one "usually" flushes with 3 or 5 mls of Heparin flush solution as the final SASH protocal. Given that most PICC lines have ID of approx 1.5-2 mls... Heparin will and does reach systemically when "locking". SO, you're under a false assumption that your protecting your pt with this method. And you are increasing infection issues with that draw.

Never said it had anything to do with the concentration and we don't flush with 3-5ml. We flush according to what the manufacturer says the priming volume is. Also, since I follow aseptic technique including mask, sterile field and sterile gloves I sincerely doubt I'm increasing the chance of infection. There is no "false assumption" here...I'm a lot smarter than that. Not only that, but the way we do it follows EBP. I'll try to find the references for you if you'd like.

We have stopped using Heparin on our PICCS and central lines. we use positive pressure bungs from Clave called a CLC 2000. It has a spring in the device which maintains a positive pressure reducing the back-flow of blood into the PICC

Quote from FlyingScotNever said it had anything to do with the concentration and we don't flush with 3-5ml. We flush according to what the manufacturer says the priming volume is. Also, since I follow aseptic technique including mask, sterile field and sterile gloves I sincerely doubt I'm increasing the chance of infection. There is no "false assumption" here...I'm a lot smarter than that. Not only that, but the way we do it follows EBP. I'll try to find the references for you if you'd like.

Quote from K+MgSO4We have stopped using Heparin on our PICCS and central lines. we use positive pressure bungs from Clave called a CLC 2000. It has a spring in the device which maintains a positive pressure reducing the back-flow of blood into the PICC

Tx you IVRUS...I was just going to correct that positive pressure cap statement.. yes the cap does not apply pressure..it is rather designed to positively displace fluid upon syringe disconnection.. It make no sense at all to discard heparin on any CVC except a hemodialysis catheter and its unnecessary. If a facility has concerns about HIT they just need to eliminate the Heparin altogether. The INS guideline that recommends using a Heparin flush on all CVCs is backed up by tons of evidence. The benefit far outweighs the risk