I have been working on a pediatric oncology, …

Comment posted Dennis Quaid and wife Sue Heparin Maker by Lauren.

I have been working on a pediatric oncology, hematology, bone marrow transplant inpatient unit as an RN for 5 years. I am not sure if you were referring to central lines, or peripheral lines when you mentioned they are to be flushed with saline only. That is not the standard of care for proper care of maintenance of a central line. Central lines go directly into the superior vena cava, and MUST be flushed with varying concentrations/doses of heparin, (depending upon the type of line, the size of the line, and the age of the patient)or they would clot off and need to be replaced. Replacement of central lines is performed under general anesthesia, and must be avoided at all cost. This is true of any patient with a cental line, including babies in the neonative intensive care unit, who weigh only grams. It is the standard of care that peripheral lines are commonly flushed with much lower doses of heparin, especially when they are very small bore, to avert clotting. This helps to avert the traumatic, painful process of re-inserting an IV catheter that could clot when not being used for infusion. All lines are first flushed with saline, and then “heplocked” with the appropriate heparin.

***Editor Note***
The lines I referred to in the article were peripheral lines, which are commonly referred to as Heparin-locks, or Saline-locks. If I had meant a central line, I would have used port-a-cath, central line, PICC, etc. You are incorrect in saying central lines are inserted using “general anesthesia.” Jugular, PICC (which is inserted in the ante-cubital), and subclavian vien central lines can all be inserted using local anethesia such as lidocaine. In the intensive care unit a patient is put into reverse trendelenburg to ensure a good blood flashback so the physician knows he/she is in the vien. A port-a-cath on the other hand, which is implanted, is inserted under general anesthesia, and is used for long term medical treatment of cancer patients most often. Using local anesthesia is preferred for everything except for a port-a-cath especially in pediatric and infants due to their sensitivity to all medications, especially someting as potent as anesthesia. Your hospital physicains may prefer to use general anesthesia for their pediatric cancer patients, however, they are putting those patients at an unnecessary risk.

Since central lines require completely different care, and are only inserted for long-term IV therapy, the nurse would not flush the line with normal saline, but would instead use Heparin. In all peripheral lines meant for short term care, and usually only last about 3 days, those lines should only be flushed with normal saline.

Thank you for reading HG Lauren, and special thanks to you for caring for those young children who need a caring caregiver the most.

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