Routine Care of CVC

5. Routine care of CVC

All nursing procedures must be done under strict aseptic technique. Observe universal precautions.

The clinician must know the type, size, manufacturer and specific characteristics of the catheter to care for the CVC. Check manufacture's instructions for catheter maintenance.

A. Maintain patency

All catheters must be flushed to maintain patency. The type of flush, frequency and amount depend upon the type and size of the catheter.

If heparin is used to maintain patency, consider SASH method (Saline, Antibiotic, Saline, Heparin) for intermittent delivery of drugs that are incompatible with heparin.
If it is used for frequent intermittent therapies, consider a TKO line or decrease the concentration of heparin flushes.
Flush after each use. Flush each lumen. Consider the volume of extension tubing for the volume of flush.
Check your institution's protocols or obtain specific order from the physician.

Recommended Flushing Protocols

TYPE OF CATHETER	AMOUNT AND TYPE OF FLUSH	FREQUENCY
Non-tunneled catheters	Heparin 100 units (I ml)	Daily & after each use
Tunneled (Hickman)	Heparin 300 units	Daily & after each use
Groshong catheter	9% sodium chloride (IO ml) 20 ml NS	Weekly & after each use After each blood draw
Port-a-cath	Heparin 500 units (5 ml)	4 weeks & after each use
PICC line	Heparin 100 units	Daily & after each use