Intravenous Push through Heparin Lock

Definition
• Heparin lock flush solution is a medication that, when injected into an IV line or
catheter, helps keep the lines open and promote free flow of blood in the lines.
• With a heparin lock IV, blood has minimal chances of clotting in IV lines due to
the anti-coagulant (anti-clotting) proteins contained in the heparin drug.
Indications
•Certain medications need to be administered to pregnant mothers going through a
low risk labor (antibiotics, pain medications, including Stadol or Demerol)
• When quicker response to the medication is required
• Administration of a “loading” dose of a medication to rapidly achieve a desired
medication level
Purposes
 Used when a rapid drug effect is desired
 Used when the medication is irritating to tissues
 Used when gastrointestinal system is not functioning.
 To decrease chances of clotting in IV lines

Materials
• IV tray
• Heparin solution
• Normal saline diluent
• 3 pieces 2.5cc syringes
• tuberculine syringe

A. IV PUSH through the HEPARIN LOCK DEVICE

Steps Rationale
1. Verify the written MD prescription and follow ∞ Ensures that correct client is receiving
hospital policy on drug administration. medication. Identification bracelets made
at the time of admission are the most
reliable source of identification.
2. Observe ten (10) Rs when preparing and
administering medications
3. Explain procedure to patient (medicine and
∞ Keeps client informed.
action) before administration
4. Do hand hygiene before and after the
∞ To maintain aseptic technique and
procedure (use gloves especially for chemo
prevent cross contamination.
drugs)
5. Gather equipment to include/but not limited
to the following:
• IV tray
• Heparin solution
 • Normal saline solution
• 3 pcs 3cc syringes
• Tuberculin syringe
6. Prepare medication to be administered e.g.,
antibiotic and draw it up into a syringe.
7. Fill a tuberculin syringe with Heparin
solution. N.B. Heparin solution is usually
prepared with 0.1 cc Heparin plus 0.9 cc
Normal saline or Isotonic solution.
8. Fill the 2.5 cc syringe with Isotonic solution
or Normal saline 1 cc each.
9. If using Hep. Loc device with 3-way stop
cock with Luer-lock, rotate the stop cock so
that the line going to the patient is closed (this ∞Maintains sterility of IV tubing for future
will prevent backflow of blood). reuse.
10. Remove the cover of the injection port
aseptically and keep the sterility of the cover
11. Check the patency, open the IV line inject
NSS or Isotonic solution to flush the Heparin ∞Ensures safe medication delivery.
solution.
12. Close the IV line & remove saline syringe
and insert medication syringe into port. ∞Ensures safe infusion rate of
medication.
13. Open the IV line & inject medication into
the vein, timing the flow rate according to
doctor’s prescription or drug manufacturer’s ∞ Ensures early identification of adverse
instructions. effects.
14. Observe patient for any adverse reactions
& do nursing intervention accordingly.
15. Close the IV line & remove medication ∞ Always flush port to prevent drug
syringe. incompatibilities. Flushing with 3 to 10 ml
16. Insert the saline syringe, open the line & of saline after each medication is crucial.
flush catheter tubing /IV cannula to flush the Volume of flush depend on lumen size
line. and catheter length.

∞ Maintains sterility of IV tubing for future

17. Close & remove saline syringe. reuse.
18. Close the IV line, remove syringe and
return the cover of the injection port ∞ To serve as a legal basis
aseptically.
19. Document in the patient’s chart and Kardex
20. Discard waste according to Health Care
Waste Management (DOH/DENR).
Note: Normal saline can take the place of
Heparin. Studies have shown the efficacy of
NSS. Heparin solution can be used if normal
saline or Isotonic solution is not available
Nursing Management

1. Before administration of the medication:

a. Dilute the medication as recommended by pharmacy references to minimize potential
irritation to the veins.
b. Determine the recommended and safest rate of administration. Most medications are
given slowly (rarely over less than one minute; longer infusion times may be needed). Too
rapid administration may result in serious adverse effects.
c. Check for possible incompatibility with existing infusions or medications. Do not administer
IV push medications into an infusion containing vasoactive agents, Heparin infusions, or
other continuously-infusing medications because you will change their rate of administration.
d. Assess the patient’s condition and ability to tolerate the medication.
e. Confirm the patency of the IV.
f. Ascertain how long the IV has been in place. For some medications, such as vesicants, a
catheter placement of ≤ 24 hours is desirable.

2. During administration:
a. Watch the patient’s reaction to the medication:
1) Assess for major side effects such as anaphylaxis, respiratory distress, tachycardia,
bradycardia, or seizures. If present, stop the medication and implement emergency
measures as needed.
2) Assess for minor side effects such as nausea, flushing, skin rash, or confusion. If present,
stop the medication and report to MD/LIP.

3. After administration, assess the patient for desired effects of the medication.

References
7th edition of the Nursing Standards on Intravenous Practice by ANSAP
Nursing Interventions and Clinical Skills; 4th edition by Potter