PROCEDURES:
* Explain the procedure to the patient prior to procedure.
* Aseptic preparation prior to commencing procedure.
* Prepare dressing pack at bedside prior to positioning patient.
* Clamp off line of CVC pigtail being heparin locked with blue slide clamp.
* Position patient in bed on back.
* Clamp off line of CVC pigtail being changed, with blue slide clamp.
* Remove Heparin label from luer lock cap on pigtail if present.
* Thoroughly swab CVC pigtail and IV line being heparin locked, 5 cm down from luer lock cap on pigtail and including yellow cap connection with Hibitane solution from dressing pack.
* Place cleaned CVC pigtail on sterile towel from dressing pack and allow solution to dry before proceeding to next step.
* Place on sterile gloves.
* Disconnect luer lock cap from CVC pigtail which has been cleaned and place on sterile towel.
* Draw out 5 mLs of blood from CVC pigtail with 5 mL syringe from dressing pack set up and discard.
* Flush CVC pigtail with 5 mls of Heparin flush, drawn up with the use of sterile gauze to maintain sterility.
* Next flush CVC pigtail with appropriate amount of Sodium Heparin 5000 u/ mL with 1 mL syringe also drawn up with the use of sterile gauze to maintain sterility.
* Do not allow entry of air into CVC pigtail through injection by syringes.
* Place new luer lock cap on CVC pigtail.
* Mark luer lock cap on CVC pigtail with green Heparin label.
* Observe for leakage or blood back up from CVC pigtail connection site.
* Label IV administration set with time and date of change.
* Record date and time of next line change on flow chart.
* Note in patients' chart that the lines have been changed and any problems noted during procedure.

R : 27.2
ADMINISTRATION
ISSUES: Standing Orders :
* Inject pigtail with the following amounts of IV Sodium Heparin

DOUBLE LUMEN
Distal ( Brown ) 0.50 mL Sodium Heparin 5000u/ s/ mL
Proximal ( White ) 0.45 mL Sodium Heparin 5000u/ s/ mL

TRIPLE LUMEN
Proximal ( White ) 0.45 mL Sodium Heparin 5000u/ s/ mL
Middle ( Blue ) 0.40 mL Sodium Heparin 5000u/ s/ mL
Distal ( Brown ) 0.50 mL Sodium Heparin 5000u/ s/ mL

QUAD LUMEN
Proximal ( White ) 0.45 mL Sodium Heparin 5000u/ s/ mL
Middle 2 ( Blue ) 0.40 mL Sodium Heparin 5000u/ s/ mL
Middle 1 ( Grey ) 0.50 mL Sodium Heparin 5000u/ s/ mL

Recording of Drug :
* The administration is to be entered on the medication chart in the same manner as a telephone order and confirmed by a Medical Officer's signature within 24 hr.
* Adopted by the Drug Committee of the Board of Directors.





R : 27.3