Heparin Flush PICC Line

Is it ok to flush PICC line with Heparin Flush daily after finishing TPN?

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First flush with 10 cc of normal saline to clean line. I recommend push stop, push stop method to create turbulence. As far as heparin I would check with your home health agency or MD for their protocol but I used 5 ml of heparin lock 100units/ ml after saline flush. This is to keep PICC line open.


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When I started on TPN 18 months ago I was instructed to flush with one 10 ml. syringe of saline. The protocols have changed and I now flush with two syringes. Once before I start my TPN.....and then again when I finish. After I unhook and flush I instill one 5 ml syringe of Heparin. I did this with my PICC line and then with my new Broviac. It didn't change when the lines were changed.
The only thing I might add is to question the 'push stop, push stop' method of flushing. I was taught this method and used it for a year. Then on another site the subject was brought up for discussion...and by a massive amount was dismissed as being possibly injurious. Apparently, according to two nurses, you can dislodge pieces of the fibrin sheath that forms on ALL line tips. It was highly recommended that a steady and gentle push be used to flush. I would talk to your Dr. or TPN nursing team to see where they sit on this one.
I've been lucky and have had no infections in the last 18 months. I have had one occlusion...and it was easily fixed by the administration of the tPa solution at my local IV clinic.
Good luck.

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Thanks for your help!

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That's a very interesting point regarding the start/stop method since that has been recommended to me both in the hospital and by home health care. I wonder if a new consensus is emerging on that. Thanks.

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