Converting a Primary Line to a Heparin or Saline Lock

Converting a Primary Line to a Heparin or Saline Lock

Equipment
■ Clean nonsterile gloves.
■ Peripheral intermittent lock adapter.
■ 2 syringes containing saline or dilute heparin solution.
■ Linen-saver pad.
■ Transparent semipermeable dressing.
■ Alcohol or other antiseptic swab.

Assessment
■ Assess the patient’s readiness to have the IV fluid discontinued and the site changed to an intermittent lock (e.g., tolerating oral fluids, adequate urine output, and laboratory values within normal limits).
■ Assess for allergy to tape.
■ Assess the IV site for signs of phlebitis, infiltration, extravasation, or infection.

Post-Procedure Reassessment
■ Evaluate catheter patency before each use and routinely every 8 to 24 hours (according to agency policy).
■ Monitor the insertion site for signs of complications, and the patient’s tolerance to the intermittent IV therapy.

Key Points
■ Be Safe! If complications are present or the IV has been in place longer than 72 to 96 hours, remove the IV catheter instead of converting it to an intermittent lock.
■ Don clean nonsterile gloves.
■ Remove the IV lock from the package, and flush the adapter.
■ Remove the IV dressing and the tape that is securing the tubing.
■ Close the roller clamp on the administration set.
■ With your nondominant hand, apply pressure over the vein just above the insertion site; stabilize the catheter hub with your thumb and forefinger.
■ Disengage the old tubing from the IV catheter.
■ Be Smart! If the tubing does not separate from the catheter, use a hemostat to gently twist the lock and separate tubing from catheter.
■ Quickly insert the lock adapter into the IV catheter and turn the lock adapter until snug.
■ Scrub the adapter injection port for at least 15 seconds.
■ Flush the lock adapter again.
■ Apply a sterile transparent semipermeable dressing.
■ Be Safe! Do not cover the lock-hub connection.
■ Label the dressing with the date and your initials.
■ Discard used supplies.
■ Be Safe! Maintain sterility of equipment throughout.

Documentation
■ Chart the date and time the IV line was converted to an intermittent lock device; the size and location of the catheter; and the type and amount of flush solution used.
■ Document the condition of the IV site and any signs of complications.
■ Record on the I&O record the amount of IV fluid infused.
■ Often, IV care is documented on a flowsheet or an electronic patient record.

Flush the adapter

Insert the adapter quickly into the catheter hub

Flush the line again after it is inserted