Heparin locking the CVL or PICC

Heparin is used to prevent blood from clotting in the central venous line (CVL) or peripherally-inserted central catheter (PICC) and blocking the line when it is not in use. This is done when the CVL/PICC is no longer required for medication or fluid infusions.

Supplies you will need

• 5 mL syringe
• 10 mL saline syringe
• 10 mL saline vial for children under 10 kg
• 20 g needle or smaller
• Heparin flush solution 100 u/mL (1000 units/10 mL re-useable vial) or pre-filled heparin syringes
• CHG or alcohol wipes
• Sharps container for needle disposal

Heparin locking procedure

1. Clean your work surface with alcohol and allow it to dry. Wash your hands and gather your supplies
2. Prepare heparin syringe as instructed for your child’s weight
• Check expiry date of heparin and saline
• Children under 10 kg will have their heparin diluted with saline
• Make sure air bubbles are removed from the syringe
3. To stop your child’s infusion, clamp the CVL/PICC and detach tubing from cap
4. Wash your hands
5. Scrub the cap vigorously with an alcohol wipe for 15 seconds. Allow cap to dry completely
6. Attach the saline syringe to the cap, unclamp the CVL/PICC and flush the line with saline using a firm pulsing motion (push/pause)
• Turbulent flushing (push/pause) is very important to clear off any residue that is stuck to the inside of the line
• Make note of any resistance when flushing. It may mean that a clot or build up is starting to form. Notify your health care team
7. Close the clamp on the line when the flushing is complete
8. Remove the saline syringe and attach the heparin syringe to the cap
• If you place the line down, scrub the cap with an alcohol swab for 15 seconds before attaching the heparin syringe
• Make sure you take the needle off the heparin syringe
9. Unclamp CVL/PICC and slowly push the prescribed amount of heparin into the CVL/PICC
• Smaller syringe sizes create higher pressure when pushing quickly into CVL/PICCs
10. Once the heparin is in the line, close the clamp on the CVL/PICC
• Clamping while pressing on the plunger will create positive pressure to prevent blood backing up in the CVL
11. Remove heparin syringe
• Dispose of supplies in appropriate container (i.e. sharps container)