Reply To: Central Lines and Heparin

  • Elissa Shulta

    January 11, 2022 at 2:26 pm

    I am also curious what other institutions have been doing since there is a heparin shortage. When our Central Access Team reached out to other pediatric institutions, they found that many of them have been flushing with saline for years now instead of heparin. They said the key with flushing with saline is in the technique. Staff must use a pulsatile motion when capping with saline and clamp the lumen before removing the syringe. 

    I also haven’t been able to find a lot of literature to support saline use vs heparin among pediatrics. The few articles that I did find used a sample of both adults and pediatrics and found that there is no evidence to support the use of heparin lock and that the prevention of occlusion is based on proper flushing technique.

    Elissa Shulta, DNP,RN,CPHON
    Clinical Nurse Specialist
    Milwaukee, WI
    United States
    Original Message:
    Sent: 08-16-2021 01:57 PM
    From: Kathleen Ackerman
    Subject: Central Lines and Heparin

    We are a pediatric hospital in a adult hospital. Our adult programs recently stopped using heparin in medport, and have not used heparin in other central lines for a couple of years. We are interested in finding out what other pediatric hospitals are doing both inpatient and outpatient. I would ask for your assistance in answering the following questions, and I will post the responses for all to see.

    1. What types of central lines do you use?  And if you could estimate percentage of pts using each line
           Medports  ________%
           Tunneled central lines  __________%
            Non-tunneled central lines __________%
            PICC’s  _________%
            Peripheral  ________%

    2. Do you use heparin in your lines?
            Medports Yes/No
            Tunneled central lines  Yes/No
            Non-tunneled central lines Yes/No
            PICC’s  Yes/No
            Peripheral Yes/No

    3. If you are no longer using heparin in lines, when did you stop?

    4. Have you noticed any increase in either alteplase usage or central line replacements?
             Alteplase   Yes/No
            Central Line Replacements  Yes/No

    Any other comments?

    Kathy Ackerman, MSN, PCNS-BC
    MSK Kids, Memorial Sloan Kettering Cancer Center
    NY, NY