We are doing a pilot study on the Bard Poly Midlines. Looking at other "tools" of access devices to offer our patients. We are finding that we are unable to draw blood after a few days or so clots off completely and needs to be removed. It has recommended that we start doing heparin flushes Q24 of 3ml of 10u/ml.
Two issuses for me. The need to hep flush midline in the first place and the use of 10u heparin vs 100u. Our pharmancy does not stock 10u so it would need to be order.
What are your thoughts on this? If we go forward with implementing midlines into our product line we would need change our policy.
Debra Rivie VAN
Long Beach Memorial Medical Center
Long Beach, CA
I recently finished a thorough lit review on flushing and locking for a couple of projects. There are many studies on locking PIVs with saline only. Now there are several well done RCT comparing locking CVADs with saline vs heparin 10 units per mL. Those solutions are equal. All studies on both PIV and CVADs show equivalent outcomes when the VAD is locked with saline vs heparin. There is never a need for heparin 100 units per mL to lock any VAD. There are no specific studies on locking midlines with any solution. So you could choose either one, but heparin 100 units should not be chosen. There is one study in JIN showing that PICCs in home care have fewer additional nursing visits when locked with heparin 10 units vs saline and heparin 100 units. There is a problem with a lack of bllood return on midlines but that does not automatically indicate that the cause is inside the lumen and would therefore be altered by the locking solution. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861