Nephrology

1214 Heparin Locking A Central Venous Catheter

  • Heparin Locking A Central Venous Catheter 

    Dual lumen perm-caths are not to be used for any purpose other than haemodialysis unless prior nephrologist permission obtained

    Aim

    To maintain catheter patency between haemodialysis sessions, by prevention of clot formation in the catheter lumen

    Procedure

    This procedure must be performed under aseptic conditions

    At the completion of washback, flush each lumen of the catheter with 10mls Normal Saline

    Instill the Heparin Lock

    The heparin lock is equal to 25 Units / kg diluted in Normal Saline up to the exact priming volume of lumen of Perm-Cath, and divided between the two lumens

    A 16kg child with a perm-cath priming volume of 0.7ml + 0.8ml (total 1.5mls)

    Instill 16 x 25 = 400 Units of Heparin into 1.5ml Normal Saline

    Use Heparin amp 1000 Units / ml 

    Draw up 0.4mls (400 U) heparin and 1.1mls Normal Saline (total 1.5 mls)

    Instill 0.7 mls into arterial lumen and 0.8 mls into venous lumen of catheter.

    If clots are present when aspirating the heparin lock, the amount of heparin in the lock can be increased up to a total of 50 Units / kg (divided between the two lumens)
    If further clots develop in the catheter lumen a referral should be made to the Haematology team for advice.
    3. Place a leur lock cap onto the ends of the catheter