How to Flush a Central Line with Heparin

Flushing your child’s central line with heparin helps keep the line clean and working well. Your care team will teach you how to flush the line safely. Follow each step carefully to help prevent infection and avoid problems. 

Keep your hands, supplies, and workspace clean when handling the central line. The line should flush easily. Never force a flush. If you have trouble flushing the line or notice signs of infection, contact your care team right away.

Gather supplies and check labels

Gather your supplies before you start. For each lumen, you will need: 

• 1 pre-filled syringe of heparin lock flush (10 units/mL) 
• 2 alcohol scrub caps 
• 1 disinfectant cap  

Make sure all packaging is intact. Check the heparin syringe label to make sure it is not expired. It should have: 

• 10 units/mL 
• 3 mL in the syringe 

Take steps to prevent infection

Infection can spread easily through germs on hands and surfaces. To help reduce the risk of infection: 

• Clean your workspace with soap and water or disinfecting wipes. Let the workspace dry before placing supplies on it. 
• Clean your hands using proper handwashing techniques. 
• If you have any concerns about contamination, start over with new materials and throw away the old ones. 

Prepare your supplies

1. Open the alcohol scrub caps. Set them on your clean work area with the open side facing up. Be careful not to touch the inside of the scrub cap.  
2. Remove the lid from the disinfectant cap. Do not remove the cap from the white plastic container. Place the cap in the container on a clean surface with the open end facing up. If the cap falls on the floor, throw it away and use a new sterile cap. 
3. Open the heparin syringe pack.  
4. Remove the syringe cap from the heparin syringe and hold it straight up. Do not touch the inside of the cap or the sterile end of the syringe. Put the cap facing up on your clean work area.  
5. Pull back slightly on the syringe plunger to release pressure.  
6. Tap the side of the syringe to move air bubbles to the top. 
7. Slowly push the plunger until the air is gone. A few drops of heparin may come out. This is OK. Stop at the 3 mL mark. 
8. Put the syringe cap back on the syringe. Set the syringe on your clean work area.  

Flush the line

When giving medicines through a central line, use the SASH method. Once medicines are no longer being given through the lines, you do not need to use saline flushes. You should continue flushing each line with heparin every 24 hours. 

Clean the needleless connector line: 

1. Remove the disinfectant cap from the needleless connector. Throw the cap away. Do not reuse the disinfectant cap. 

2. Clean the connector with an alcohol scrub cap. 

a. Push the alcohol scrub cap onto the needleless connector.  

b. Twist it back and forth for 10 seconds.  

c. Remove the alcohol scrub cap. 

d. Let the connector dry for 5 seconds. Do not blow on it. 

Flush the line: 

The line should flush easily. Do not force the flush.  

3. Remove the syringe cap from the syringe. Do not touch the syringe tip or the clean connector. (If you touch the clean connector by mistake, clean it again with a new alcohol scrub cap for 10 seconds. Let it dry completely before using it.) 

4. Screw the syringe onto the needleless connector. Make sure the connection is tight. 

5. Unclamp the line. 

6. Flush using a push-stop motion with the heparin syringe. (Push a small amount of heparin. Then stop. Then repeat. 

7. Stop when you reach the 1mL mark. 

8. Use your free hand to hold the clamp between your fingers. 

9. Push the plunger until all of the heparin is gone. 

10. Clamp the line while you are still pushing the plunger.  

11. Unscrew the syringe from the connector. 

Clean the needleless connector again: 

12. Clean the connector with an alcohol scrub cap. 

a. Push the alcohol scrub cap onto the needleless connector.  

b. Twist it back and forth for 10 seconds.  

c. Remove the alcohol scrub cap. 

d. Let the connector dry for 5 seconds. Do not blow on it. 

Apply a new disinfectant cap: 

13. Place a new disinfectant cap on the end. 

14. Throw used supplies in the regular trash. 

15. Wash your hands. 

Troubleshooting your central line

If the line does not flush easily: 

1. Make sure the clamp is open.  
2. Check the line for bends or kinks.  
3. Change your child’s position. Try having them raise their arm or turn their head. 
4. Make sure the syringe is connected tightly.  

If you cannot flush the line easily or have questions about how to flush it, clean the needleless connector and put on a new disinfectant cap. Then, call your care team: 

• In the local area: 901-595-3300 
• Outside the Memphis area: 1-866-278-5833

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