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Oncology - care of the oncology patient admitted to PICU - intravenous lines

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  • Intravascular line care is as per the PICU protocols
  • ALL dressing and cap changes are to be completed in a STERILE manner.
  • Patients are treated as high risk for CLAB
  • Subcutaneous Port needles need to be changed every 7 days (they are in the PICU compactors).
  • Please use a clear dressing for ALL CVLs so the site can be seen and assessed for infection.
  • If line blocked consider use of alteplase to unblock.
  • Please follow the following CVL protocol for heparin flushes
    • At least Q8H with heparin of 10 units/ml (50units/5mls) where a continuous infusion is not in progress but the CVC is in regular use.
    • Every 7 days with heparin 100units/ml (200units/2mls) in a tunnelled cuffed CVC or a PICC line when not in regular use
    • Every 4 weeks with heparin 100units/ml (200units/2ml) in a subcutaneously implanted catheter (Port) when not in regular use as prescribed
    • Between therapy, with heparin 1000units/ml in apheresis/haemodialysis type catheters for PICU and Haematology / Oncology patients as prescribed
    • Between therapy with heparin 5000unit/ml for haemodialysis patients as prescribed
    • Infants less than 5 kg in PICU will have a continuous low dose heparin infusion administered as prescribed via their CVC until removal of the CVC
 Type of line Heparin volume Heparin strength (catheter not in regular use)
 Portacath 2ml 100 units/ml monthly 
 Hickman and Broviac <1yr = 0.5ml
>1yr = 1ml
100 units/ml every 7 days
 PICC <1yr = 0.5ml
>1yr = 1ml 
100 units/ml every 7 days 
Haemodialysis Catheters (Vascath, Permacath, Haemacath)
Haematology / Oncology / PICU patients
Use intraluminal volumes specified on the  catheters.
Exact volumes to be used.
1000 units/ml between therapy up to weekly
Haematology / Oncology / PICU patients only 
Haemodialysis Catheters (Vascath, Permacath, Haemacath)
haemodialysis patients only
Use intraluminal volumes specified on the catheters.
Exact volumes to be used.
5000 units/ml between therapy
Renal haemodialysis patients only

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Document Control

  • Date last published: 10 June 2016
  • Document type: Clinical Guideline
  • Services responsible: Paediatric Intensive Care Unit
  • Owner: Fiona Miles
  • Editor: John Beca
  • Review frequency: 2 years