Reply To: High Dose Heparin

  • Louis Ruggiero

    August 6, 2020 at 1:44 pm

    For pheresis and HD lines that are also being used for treatment we have different caps being used. If a tego cap is present on the line (which is what’s used by the pheresis and dialysis teams), that cues the RN that high dose heparin is in the line and before using will need to withdraw the heparin. Our teams sometimes use line labeling as well but I find that it’s not as reliable due to lack of consistency and that they peel off.

    Louis Ruggiero, MSN, RN, CPHON
    Clinical Educator – Infusion Center
    Children’s Hospital Los Angeles
    Original Message:
    Sent: 08-06-2020 07:55 AM
    From: Chris Donaghey
    Subject: High Dose Heparin


    We have had multiple recent issues with high dose heparin use for our large bore catheters, especially remarkable on our stem cell transplant unit as they take dialysis patients, too. Nurses are forgetting to aspirate the HD heparin for various reasons.

    What do your nurses do with large bore lumens in order to prevent errors from occurring? Line labeling? Alternative local processes?

    Thanks everyone for your thoughts and ideas.

    Chris Donaghey, MSN, RN, PCNS-BC, CPN, CPHON
    Clinical Nurse Specialist – Cancer and Blood Diseases
    Riley Hospital for Children at IU Health
    Indianapolis, IN