Anti X-a off line

We have just been told that best practice now dictates that anti x-a's cannot be drawn off central lines. The rationale being that heparin stays in the lumen of the line and skews the results.

We have always turned off the heparin for 5 minutes, flushed x 3, drawn the lab and flushed again. Even better if it is a TLC. I have always found that this was "reliable" i.e. the heparin turned up or down and was therapeutic after a couple of labs.

I will be researching this on my own but wanted to see if this was 'best practice' where you work.

Thoughts?
Yes. Like you, it is a recent change. Patients get pretty upset about it given how often they have to be stuck.

Yes! People don't want to be stuck over and over that's why they have a line. Still researching...

We don't use the same lumen the heparin is infusing through, but there shouldn't be a problem using a different lumen to draw labs from. If the patient is a difficult stick and only has a single lumen CL or PICC then we try to get a peripheral in, run the heparin through the peripheral and draw coags off of the CL or PICC. If all else fails and q 6hr peripheral sticks are problematic then we flush the lumen with 30cc, wait a few minutes and draw.

What is an anti x-a?

Quote from Not_A_Hat_PersonWhat is an anti x-a?

Interesting, I've only seen anti factor Xa's for LMWH dosing. We exceedingly rarely do heparin drips, but when we do, we titrate on APTT's. We draw them off a different lumen of the CVL. We draw anti factor Xa's off lines too, but obviously not an issue since the LMWH is subq.