Heparinizing a peripheral IV

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Why do I need to heparinize the peripheral IV?

Heparin will prevent blood from clotting and blocking the line.

How often do I need to heparinize the peripheral IV?

The peripheral IV needs to be heparinized once a day if your child or teen is not on a continuous IV infusion. You will need to heparinize the IV after the medication or solution has finished infusing.

What you need:

• 3 ml syringe
• Blunt needle
• Vial of Heparin 100 u/ml
• 1-2 pre-filled 0.9% Sodium Chloride syringes
• 4x4 sterile gauze
• 2 x 2% Chlorhexidine & 2 x 70 % alcohol swabs
• Sharp container
• Non-sterile gloves

Instructions

1. Assemble equipment and wash hands.
2. Check the expiry date and dose on the heparin vial.  If a multi-dose Heparin vial is in use, check the expiry date (Heparin is good for 30 days from when opened.)
3. Pop the cap off the Heparin vial if this is the first use. Clean the rubber stopper on the vial of heparin with a 70% Alcohol swab for 15 seconds and allow to dry for 15 seconds. 
4. Open the package containing the 3 ml syringe and attach the blunt needle.
5. Remove the protective cover from the blunt needle and draw back on plunger of 3 ml syringe to 0.8 ml. One vial of heparin contains enough solution for 6 days of heparinizing the peripheral IV.
6. Insert blunt needle into heparin vial and push in air. Invert vial and draw up required amount of heparin into syringe 0.8ml for peripheral IV.
7. Remove all air in the syringe and apply the cap onto the needle and place the syringe on your work area. Flick barrel of syringe or tap syringe to get all bubbles to top of syringe which may be caught at the bottom of syringe.
8. Remove the pre-filled 0.9% Sodium Chloride syringe from the package. Remove the white cap and remove all air bubbles from syringe. Put back white cap.
9. If IV is attached to IV infusion, turn off infusion pump and close clamp on the IV tubing.
10. Wash your hands and put on non-sterile gloves.
11. Open the package of sterile gauze and alcohol swabs. Apply swab to sterile gauze.
12. Remove the IV tubing from the IV and discard (if applicable).New tubing needs to be primed if your child or teen needs to go back on IV infusion.
13. Grasp IV connector cap with 4x4 gauze and clean end of connector with an alcohol swab for 15 seconds. Allow to air dry for 15 seconds. 70% alcohol needs at least 15 seconds cleaning time to be most effective. Air drying prevents cleaning solution from getting into the valve. 
14. Remove the white cap from the pre-filled 10 ml 0.9% Sodium Chloride syringe. Attach it to the connector port. Flush the catheter with 1-2 ml. Using light pressure pull back on the plunger to check for blood return. Then flush rest of the 0.9% Sodium Chloride to clear the line. Watch for any resistance, pain, discomfort or leakage of fluid around the IV. If Peripheral IV has been in for few days, of if it is a small size catheter, it is very likely that there will be no blood return.
15. Remove the Sodium Chloride syringe.
16. Remove the blunt needle and attach the syringe containing the heparin solution to the connector cap. Flush all of the heparin solution into the peripheral IV. Keep your thumb on the end of the syringe plunger while you close the clamp on the IV. Keeping your thumb on the plunger while you close the clamp keeps positive pressure in the IV so that blood does not back up into the IV tubing before the clamp is closed. If using positive pressure connector cap, remove the syringe first and then clamp the tubing.
17. Remove the syringe and dispose of all equipment into appropriate receptacles.