Flushing CVAD lumens

[COCKS Joanne M (SVHM)]

Hi All

I am reviewing our current CVAD policy – and I need to include an item around flushing un-used lumens

1. Do you flush all un-used lumens (if not heparin locked) for all patients? Or just some groups of patients? E.g Haematology

2. If you flush – how often – e.g once per shift, once per day?

3. Does anyone replace CVAD (using a guidewire) in the situation where the CVAD in-situ has (for example) 5 lumens – inserted in ICU – and on transfer to the wards only needs 2 lumens for on-going clinical management. Providing there is no evidence of sepsis, insertion site is OK etc. Or do you leave the 5 lumen CVAD in and flush the lumens or just note they are not in use and not use them form this point on

The CDC guidelines don’t address flushing of lumens, I can only find it addressed in Oncology (referenced to UK Guidelines) and the ANZICS guide (not referenced)

Thanks for the help

Regards

Jo

Joanne Cocks | Infection Control Coordinator
St Vincent’s Melbourne | PO Box 2900 | 41 Victoria Parade, Fitzroy VIC 3065
t: +61 3 9288 4069 | f: +61 3 9288 4068 http://www.svhm.org.au
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[Janet Masters]

Hi Jo
ICCMU (the Intensive Care Coordination and Monitoring Unit) – Part of NSW
Health is in the final stages of developing a consensus and evidence based
Clinical Practice Guideline – part of it is loaded into their wiki (
http://intensivecare.hsnet.nsw.gov.au/icwiki/index.php/Welcome_to_ICWiki)
and I hope to get the rest of it up tomorrow (the IT gods willing). The
guideline has been developed by ICU and Vascular Access Nurses following a
systematic review (it is being presented as a poster at the Australian and
New Zealand Intensive Care Annual Scientific Meeting in October). The
guideline had ICP input. There is recommendations about flushing but I can
not remember what they said – the recommendation statements are in the wiki
– its the narrative that will go up tomorrow which discusses the evidence.

Janet
Ex ICP Blacktown Mt Druitt Health
Currently Intensive Care Best Practice Project Officer
ACI – ICCMU / Nursing and Midwifery Office (till Friday)

On 25 September 2013 16:36, COCKS Joanne M (SVHM)
wrote:

> Hi All****
>
> ** **
>
> I am reviewing our current CVAD policy and I need to include an item
> around *flushing un-used lumens*****
>
> ** **
>
> **1. **Do you flush all un-used lumens (if not heparin locked) for
> all patients? Or just some groups of patients? E.g Haematology****
>
> **2. **If you flush how often e.g once per shift, once per day?*
> ***
>
> **3. **Does anyone replace CVAD (using a guidewire) in the
> situation where the CVAD in-situ has (for example) 5 lumens inserted in
> ICU – and on transfer to the wards only needs 2 lumens for on-going
> clinical management. Providing there is no evidence of sepsis, insertion
> site is OK etc. Or do you leave the 5 lumen CVAD in and flush the lumens
> or just note they are not in use and not use them form this point on****
>
> ** **
>
> The CDC guidelines dont address flushing of lumens, I can only find it
> addressed in Oncology (referenced to UK Guidelines) and the ANZICS guide
> (not referenced)****
>
> ** **
>
> Thanks for the help****
>
> ** **
>
> Regards****
>
> ** **
>
> Jo****
>
> ** **
>
> Joanne Cocks | Infection Control Coordinator****
>
> St Vincents Melbourne | PO Box 2900 | 41 Victoria Parade, Fitzroy VIC
> 3065 ****
>
> t: +61 3 9288 4069 | f: +61 3 9288 4068 http://www.svhm.org.au****
>
> [image: Description: cid:image002.jpg@01CE2B97.03F7F180]****
>
> ** **
>
> ** **
>
> Disclaimer : The contents of this e-mail including any attachments are
> intended only for the person or entity to which this e-mail is addressed
> and may contain confidential, privileged and/or commercially sensitive
> material. If you are not, or believe you may not be, the intended
> recipient, please advise the sender immediately by return e-mail, delete
> this e-mail and destroy any copies.
> ______________________________________________________________________
> This email has been scanned by the Symantec Email Security.cloud service.
> For more information please visit http://www.symanteccloud.com
> ______________________________________________________________________
> MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
> NOT REPRESENT THE OPINION OF ACIPC.
>
> The use of trade/product/commercial brand names through the list is
> discouraged by ACIPC. If you wish to discuss specific reference to products
> or services by brand or commercial names, please do this outside the list.
>
> Archive of all messages are available at http://aicalist.org.au/archives- registration and login required.
>
> Replies to this message will be directed back to the list. To create a new
> message send an email to aicalist@aicalist.org.au
>
> To send a message to the list administrator send an email to
> aicalist-request@aicalist.org.au.
>
> You can unsubscribe from this list be sending ‘signoff aicalist’ (without
> the quotes) to listserv@aicalist.org.au
>

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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