Incompatible: NS, sodium bicarbonate pH: 3.5-4.5 Irritant, use central line if possible, especially for repeated or continuous infusions. Use via peripheral lines may cause discomfort and inflammation. Monitor: BP, HR, RR, rapid administration may cause hypotension &. According to our hospital policies, indications for PICC insertion were (a) need for a central line for parenteral nutrition, and/or infusion of drugs that require a central line (pH 9, osmolarity 500 mOsm/l, drugs associated with endothelial damage), and/or (b) central venous pressure monitoring, and/or (c) need for frequent blood.
Medically reviewed by Drugs.com. Last updated on Jun 24, 2019.
- Dosage
Applies to the following strengths: 100 units/mL; 10 units/mL; 2 units/mL-NaCl 0.9%; 0.5 units/mL-NaCl 0.45%; 0.5 unit/mL-D10%; 90 units/mL-NaCl 0.9%; 1 unit/mL-NaCl 0.9%; 1 unit/mL-NaCl 0.225%; 1 unit/mL-NaCl 0.45%; 0.5 units/mL-NaCl 0.9%; 1 unit/mL-D10%; 125 units/250 mL-D10%; 10 units/mL-NaCl 0.9%; 1 unit/mL-D5%; 4 units/mL-NaCl 0.9%; 5 units/mL-NaCl 0.9%; 3 units/mL-NaCl 0.9%; 1 units/mL; 2 units/mL
Usual Adult Dose for:
Usual Pediatric Dose for:
Additional dosage information:
Usual Adult Dose for Patency Maintenance of Indwelling Intravenous Devices
Heparin flush, 10 or 100 units/mL, is injected as a single dose into an intravenous injection device using a volume of solution equivalent to that of the indwelling venipuncture device.
When using daily flushes of heparin to maintain patency of single and double lumen central catheters, 10 units/mL is commonly used for younger infants (less than 10 kg) while 100 units/mL is used for older infants, children, and adults.
A single dose should be injected following venipuncture when the indwelling device is not to be used immediately. After each use of the indwelling venipuncture device for injection or infusion of medication, or withdrawal of blood samples, another dose should be injected to restore the effectiveness of the heparin lock. The amount of heparin solution is sufficient to prevent clotting within the lumen of indwelling venipuncture devices (usually not holding more than 0.2 to 0.3 mL) for up to twenty-four hours.
When the indwelling device is used to administer a drug which is incompatible with heparin, the entire heparin lock set should be flushed with 0.9% Sodium Chloride Injection, USP before and after the medication is administered. Following the second flush, another dose of heparin solution should be injected to restore the effectiveness of the heparin lock. When the indwelling device is used for repeated withdrawal of blood samples for laboratory analyses and the presence of heparin or saline is likely to interfere with or alter results of the desired blood tests, the in situ heparin flush solution should be cleared from the device by aspirating and discarding 1 mL before the desired blood sample is drawn.
When using daily flushes of heparin to maintain patency of single and double lumen central catheters, 10 units/mL is commonly used for younger infants (less than 10 kg) while 100 units/mL is used for older infants, children, and adults.
A single dose should be injected following venipuncture when the indwelling device is not to be used immediately. After each use of the indwelling venipuncture device for injection or infusion of medication, or withdrawal of blood samples, another dose should be injected to restore the effectiveness of the heparin lock. The amount of heparin solution is sufficient to prevent clotting within the lumen of indwelling venipuncture devices (usually not holding more than 0.2 to 0.3 mL) for up to twenty-four hours.
When the indwelling device is used to administer a drug which is incompatible with heparin, the entire heparin lock set should be flushed with 0.9% Sodium Chloride Injection, USP before and after the medication is administered. Following the second flush, another dose of heparin solution should be injected to restore the effectiveness of the heparin lock. When the indwelling device is used for repeated withdrawal of blood samples for laboratory analyses and the presence of heparin or saline is likely to interfere with or alter results of the desired blood tests, the in situ heparin flush solution should be cleared from the device by aspirating and discarding 1 mL before the desired blood sample is drawn.
Usual Pediatric Dose for Patency Maintenance of Indwelling Intravenous Devices
Arterial lines: Heparinize with a usual final concentration of 1 unit/mL; range: 0.5 to 2 units/mL; in order to avoid large total doses and systemic effects, use 0.5 unit/mL in low birth weight/premature newborns and in other patients receiving multiple lines containing heparin.
Peripheral arterial catheters in situ: Neonates and Children: Continuous IV infusion of heparin at a final concentration of 5 units/mL at 1 mL/hour.
Umbilical artery catheter (UAC) prophylaxis: Neonates: Low-dose heparin continuous IV infusion via the UAC with a heparin concentration of 0.25 to 1 unit/mL.
Prophylaxis for cardiac catheterization via an artery: Neonates and Children: IV: Bolus: 100 to 150 units/kg; for prolonged procedures, further doses may be required.
Peripheral arterial catheters in situ: Neonates and Children: Continuous IV infusion of heparin at a final concentration of 5 units/mL at 1 mL/hour.
Umbilical artery catheter (UAC) prophylaxis: Neonates: Low-dose heparin continuous IV infusion via the UAC with a heparin concentration of 0.25 to 1 unit/mL.
Prophylaxis for cardiac catheterization via an artery: Neonates and Children: IV: Bolus: 100 to 150 units/kg; for prolonged procedures, further doses may be required.
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Precautions
Benzyl alcohol, a preservative in the multiple-dose vial preparations of Heparin Lock Flush Solution, USP has been associated with toxicity in neonates. Benzyl alcohol has been reported to be associated with a fetal 'Gasping Syndrome' in premature infants. Data are unavailable on the toxicity of other preservatives in this age group. Preservative-free Heparin Lock Flush Solution, USP should be used for maintaining patency of intravenous injection devices in neonates.
Many concentrations of heparin are available and range from 1 unit/mL to 20,000 units/mL. Carefully examine each prefilled syringe or vial prior to use to ensure that the correct concentration is chosen. Heparin lock flush solution is intended only to maintain patency of IV devices and is not to be used for anticoagulant therapy.
Many concentrations of heparin are available and range from 1 unit/mL to 20,000 units/mL. Carefully examine each prefilled syringe or vial prior to use to ensure that the correct concentration is chosen. Heparin lock flush solution is intended only to maintain patency of IV devices and is not to be used for anticoagulant therapy.
Dialysis
Data not available
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
More about heparin flush
Consumer resources
Other brands:Monoject Prefill Advanced, PosiFlush
Related treatment guides
Your IV access will be prescribed by your healthcare provider. Typically, you will be sent to a local infusion center or out-patient facility to have this placed. Following is a description of the most common types of access.
Peripheral IVs are used when the patient requires intravenous access for a short period of time. Peripheral IVs infiltrate easily – they do not last in the vein longer than a few days. They are usually inserted in the hand or forearm and are only about 1 – 1 ½ inches long. They are inserted with a needle covered with a plastic catheter. The needle is removed and the catheter stays in the vein.
Central Venous Lines – a central line is a general term for an intravenous catheter whose tip ends in a large blood vessel, usually the superior vena cava, close to the right atrium of the heart. Central lines are used for patients that require IVs for a longer period of time, frequent blood draws, or medications that can be caustic to the smaller veins. After placement, they require an x-ray to make sure the tip is in the proper place. There are several types of central lines, and each has advantages and disadvantages.
- PICC Lines – PICC stands for Peripherally Inserted Central Catheter. This line is typically inserted in the upper arm and is long enough to thread through the veins in the arm to the large vessel that goes into the heart. PICC lines can have a single or multiple lumens. A double lumen line contains two separate openings through the same catheter so that two solutions or medications that are not compatible can be given simultaneously.
- Port (or Portacath) is placed under the skin in the chest and is comprised of two parts – the catheter that ends in the large vein close to the heart and the connected “port” that is usually placed in the chest below the collar bone. This port has a septum that is pierced with a right angled (Huber) needle whenever an infusion of fluids or medication needs to occur. The needle can stay in for a week, or it can come out each time an infusion is finished. The port may be pierced many times without it weakening. When the port in not accessed with a needle, it is unobtrusive, no dressing is required and the patient can swim, shower, etc.
- Tunneled Catheter – This is a catheter that is inserted typically in the chest and then threaded through a “tunnel” of tissue until it enters the vein. This helps anchor the catheter. This type of catheter can also have a single or multiple lumens.
Other Information
- Sometimes tunneled catheters are called “Hickman” or “Broviac” – this is actually the brand of the catheter, not the type of catheter.
- Power PICCs, Power Ports – these catheters allow a large volume of viscous solution to be infused quickly without rupturing, required for certain diagnostic tests. For general use at home they are treated just like any other catheter.
- All catheters must be flushed periodically either with saline, heparin or both. Generally if ports are not in use, they can be flushed with saline and heparin once/month. Other types of catheters require both saline and heparin at least once/day. Groshong catheters (specific brand, there may be others) do not require heparin although heparin will not hurt them.
- Central catheters are made out of a flexible material and placed with guide wires which are then removed.