Policy for Accessing Central Venous Catheters

Catheter Type	Catheter Flush Protocol
Temporary non-tunneled catheter Subclavian Internal jugular Femoral	Flush capped lumens with 10 ml of Normal Saline every 12 hours Lumens being utilized for intermittent infusion may be flushed with 10 ml of Normal after each use.
Tunneled Catheters Ÿ  Hickman Ÿ  Broviac Ÿ  Groshong	Flush with 10 ml of Normal Saline followed by 3 ml of 100 units/ml heparin after each use and weekly if capped. Note: Groshong catheters and other valved catheters do not require heparin: check manufacturer
Implanted Ports Infusaport Pasport	Flush with 10 ml of Normal Saline followed by 5 ml of 100 units/ml heparin after each use and before deaccessing (through huber needle). When not in use flush every 30 days. Valved ports do not require heparin: check manufacturer
PICC and Midline	Flush with 10 ml Normal Saline followed by 3 ml of 100 units/ml heparin after each use or daily if capped. (20 ml NS flush after blood infusion or withdrawal) Valved PICCs do not require heparin: check manufacturer
Permacath Quinton Neostar (triple lumen catheter)	Flush with 10 ml Normal saline followed by 3 ml of 1,000 units/ml heparin after each use or every 72 hours if capped. Note: Hemodialysis RN may access Catheters inserted for hemodialysis only.

Blood draws:                Discard 5 ml of blood before obtaining specimen

                                    TPN: Flush line with 20 ml of Normal Saline prior to 5cc discard

                                    Flush  lines with 10 cc normal saline (20 ml for PICC and Midline) following blood infusion

or withdrawal prior to resuming infusion or perform appropriate flushing protocol if capped.

                                      

Tubing Change:             Every 96 hours. Exception: TPN tubing every 24 hours.

Cap/Needle Change:      Every week if capped or every 96 hours with tubing change for continuous infusions.

                                    Huber needles are changed every week with the dressing change.

Dressing change:          When damp, loosened or soiled or when inspection of site is necessary

                                    MVP transparent dressings every week and prn

                                    Gauze dressings every 48 hours

                                    Outpatient gauze dressings every 72 hours

Newly inserted tunneled catheters: check the site at 48 hours and apply new gauze dressing for 48 hours (72 hours for outpatient). Replace with gauze or transparent dressing.

                                    Replace statlock every week with dressing change and prn

References
Guidelines for care of the venous access device. Retrieved from Detroit Medical Center Policies website: https://extraweb.dmc.org/default.aspx?ifsrc=/main_dmcinfo/policies/default.asp?col=1