Heparinising an intravenous catheter

1. BLUE TRAY OR EQUIVALENT
2. APRON
3. PAIR OF NON STERILE GLOVES (appropriate size)
4. 5mL AMPOULE SODIUM CHLORIDE 0.9% FOR INJECTION
5. 5mL AMPOULE HEPARIN SODIUM (10 UNITS PER mL FOR INJECTION)
6. 10mL LUER LOCK SYRINGES x 2
7. GREEN NEEDLE 21G x 1
8. FILTER NEEDLE 19G x 1
9. SYRINGE CAP
10. SODIUM CHLORIDE 0.9% LABEL
11. HEPARIN SODIUM LABEL
12. ALCOHOL 70% & CHLORHEXIDINE 2% WIPES
13. ALCOHOL HAND RUB
14. SHARPS BIN

DO NOT TOUCH KEY PARTS - DISCARD IF CONTAMINATED

1. Wash and dry hands
2. Clean tray inside and out with an alcohol 70% & chlorhexidine 2% wipe and allow to dry
3. Put on apron
4. Apply alcohol hand rub and allow to dry for 30 seconds
5. Put on non sterile gloves
6. Attach green needle to one syringe and filter needle to another syringe
7. Check sodium chloride 0.9% and heparin sodium (10 units per mL) ampoules with a registered nurse
8. Using syringe with green needle draw up the 5mL of sodium chloride 0.9%
9. Remove green needle from the syringe and dispose in sharps bin and then remove any air present from the syringe attach syringe cap. Affix sodium chloride 0.9% label to syringe
10. Using syringe with filter needle draw up 3mL of heparin sodium (10 units per mL)
11. Remove the filter needle from the syringe and dispose in sharps bin and then remove any air present from the syringe, attach syringe cap. Affix heparin sodium label
12. Clamp intravenous catheter and disconnect the giving set from the Smartsite®
13. Clean the Smartsite® on the intravenous catheter with an alcohol 70% & chlorhexidine 2% wipe and allow to dry for 30 seconds
14. Connect syringe containing the sodium chloride 0.9% to the Smartsite® and turn ¼ of a circle
15. Check the line for flashback of blood
16. Slowly inject the sodium chloride using a pulsing action.IF RESISTANCE IS PRESENT, YOU MUST CONTACT MEDICAL STAFF AND
    GET FURTHER INSTRUCTIONSDO NOT USE EXCESSIVE FORCE AS THIS MAY DAMAGE THE CATHETER.
    DO NOT USE ANY LESS THAN A 10ml SYRINGE TO CHECK PATENCY OF LINE
17. Holding the syringe, remove it from the Smartsite® and discard directly into sharps bin
18. Connect syringe containing heparin sodium (10 units per mL) to the Smartsite® and turn ¼ of a circle. If using a Portacath and gripper needle is being removed follow policy for removal of gripper
19. Slowly inject the heparin sodium using a pulsing action. Do not inject the full amount too
    quickly. Continue to inject the last 1mL whilst closing the clamp at the same time. In this way you keep a positive pressure in the catheter and prevent backflow of blood
20. Holding the syringe, remove it from the Smartsite® and discard directly into the sharps bin
21. Tape the catheter to the chest with the injection site in the upright position or place in a
    protective pocket, above the level of the heart to prevent flashback of blood