Utilization of Saline or Heparin Locks for Moms in Labor

 

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The saline or heparin lock is a type of venous access. It is more commonly known as an IV or an intravenous catheter. Saline locks are routinely used for most women when they are admitted to the hospital in labor.

Having this IV or saline lock in place allows for immediate access to your vein. The use of saline locks is most common because it is cost effective and does not carry some of the risks that come with using heparin locks. It is also proven to be just as effective as heparin. So why might a saline lock be used during labor and delivery? It can be used to administer IV pain medications, anti-nausea drugs, or antibiotics (in cases of Group B strep).

If you receive Pitocin for induction or labor augmentation, then Pitocin has to be given through an IV infusion—and the saline lock will be hooked up to tubing and an IV pump/pole to continuously deliver the Pitocin through your IV. Today, saline solution is typically used instead of heparin, so it’s more accurate to call it a saline lock instead. Despite this, the words hep-lock and saline lock are often used interchangeably by many non-medical people.

What are the benefits of an IV hep-lock? During a low-risk natural birth in a hospital, an IV hep-lock is the ideal. pregnancy use of heparin flushes would improve inter-mittent IV lock patency, compared with normal saline flushes.

In a double-blind study including 44 pregnant women who were between 26 and 34 weeks gestation and required serial phlebotomy, Meyer et al. compared heparin sodium (100 U/mL) with normal saline for use in the maintenance of IV locks. intravenous locks. BACKGROUND: Heparin is usually used as a regular flush solution to prevent occlusion of peripheral intravenous locks in neonates. There is no clear recommendation using heparin or saline flushing peripheral intravenous locks in neonates. The disadvantage of.

Hospitals will typically insert a saline or heparin lock upon admission so it can be quickly hooked up to an IV later, either to administer medications or fluids. Other hospitals will insert the lock and hook you to an IV from the start. Some mothers decline the IV because it restricts movement.

Saline Lock. Saline locks are the better choice (if possible) for cost and quality control reasons. The cost of saline vs. heparin is considerably less and when factoring the risks associated with heparin is the safer choice. Because they each function identically in preventing blockages, reducing inflammation and increasing duration, saline should also be the preferred choice. Therefore, since you are likely to arrive at hospital after 3-4cm, in active labor, you can have saline/heparin lock placed on admission.

Then when you feel you are ready for epidural they will be able to hook up infusion easily. To use heparin locks, care providers will wipe off the plug, insert a needle, and flush the lock with heparin or saline, depending on hospital protocol. This keeps the line clear and prevents clotting.

It also allows the care provider to confirm that blood wells up into the lock, indicating that the needle is still in the right place.

List of related literature:

Enoxaparin is sometimes used, but clients are typically switched to heparin near labor because enoxaparin used along with spinal or epidural anesthesia presents an increased risk of bleeding in the epidural or spinal space.

“Lippincott Q&A Review for NCLEX-RN” by Diane Billings, Desiree Hensel
from Lippincott Q&A Review for NCLEX-RN
by Diane Billings, Desiree Hensel
Wolters Kluwer Health, 2016

This procedure (called a heparin lock) allows the mother more freedom to move around than does an intravenous line.

“The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth” by Penny Simkin
from The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth
by Penny Simkin
Harvard Common Press, 2001

The saline lock allows freedom of movement when walking during early labor but provides quick access if fluids or medications are needed.

“Foundations of Maternal-Newborn and Women's Health Nursing E-Book” by Sharon Smith Murray, Emily Slone McKinney
from Foundations of Maternal-Newborn and Women’s Health Nursing E-Book
by Sharon Smith Murray, Emily Slone McKinney
Elsevier Health Sciences, 2017

Intravenous heparin is the initial treatment of choice for pulmonary embolism during pregnancy because it does not cross the placenta and the best choice for labor because of its short half-life.

“Perinatal Nursing” by Kathleen Rice Simpson, Patricia A. Creehan, Association of Women's Health, Obstetric, and Neonatal Nurses
from Perinatal Nursing
by Kathleen Rice Simpson, Patricia A. Creehan, Association of Women’s Health, Obstetric, and Neonatal Nurses
Wolters Kluwer Health/Lippincott Williams & Wilkins, 2008

In a nondistressed newborn infant requiring parenteral fluids, under no circumstances should an umbilical vessel catheter be used when a peripheral intravenous line could be started via a scalp vein or an extremity vein.

“Klaus and Fanaroff's Care of the High-Risk Neonate E-Book” by Avroy A. Fanaroff, Jonathan M Fanaroff
from Klaus and Fanaroff’s Care of the High-Risk Neonate E-Book
by Avroy A. Fanaroff, Jonathan M Fanaroff
Elsevier Health Sciences, 2019

Women who have a suspected or confirmed pulmonary embolism in late pregnancy should be treated with supplemental oxygen (to achieve an oxygen saturation of > 95%) and intravenous heparin, and should be transferred to a hospital that has a maternal–fetal, neonatal and cardiothoracic unit for high-risk patients.

“Emergency and Trauma Care for Nurses and Paramedics” by Kate Curtis, Clair Ramsden
from Emergency and Trauma Care for Nurses and Paramedics
by Kate Curtis, Clair Ramsden
Elsevier Health Sciences, 2011

An IV intracatheter is used to permit the woman more free movement of her arm without trauma to the involved blood vesseland has the best chance of staying in the vein if she becomes physically active during labor.

“A Comprehensive Textbook of Midwifery & Gynecological Nursing” by Annamma Jacob
from A Comprehensive Textbook of Midwifery & Gynecological Nursing
by Annamma Jacob
Jaypee Brothers,Medical Publishers Pvt. Limited, 2018

Surfactant therapy is also being used in infants with meconium aspiration, infectious pneumonia, sepsis, persistent pulmonary hypertension, and congenital diaphragmatic hernia (Polin, Carlo, and American Academy of Pediatrics, Committee on Fetus and Newborn, 2014).

“Wong's Essentials of Pediatric Nursing: Second South Asian Edition” by A. Judie
from Wong’s Essentials of Pediatric Nursing: Second South Asian Edition
by A. Judie
Elsevier Health Sciences, 2018

Usually this risk is increased if the patient is also using heparin during her pregnancy (Kuczkowski, 2006).

“Labor and Delivery Nursing: Guide to Evidence-Based Practice” by Michelle Murray, PhD, RNC, Gayle Huelsmann, BSN, RNC
from Labor and Delivery Nursing: Guide to Evidence-Based Practice
by Michelle Murray, PhD, RNC, Gayle Huelsmann, BSN, RNC
Springer Publishing Company, 2008

As an alternative to routineintubation and early/prophylactic use of surfactant, the use of nasal continuous positive airway pressure (NCPAP) in the delivery room is a potentially better practice to reduce the incidence of BPD in the very low-birth-weight preterm infant.

“Certification and Core Review for Neonatal Intensive Care Nursing E-Book” by AACN, AWHONN, NANN, Robin L. Watson, Beth C. Diehl
from Certification and Core Review for Neonatal Intensive Care Nursing E-Book
by AACN, AWHONN, et. al.
Elsevier Health Sciences, 2016

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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  • initially when you connect your saline syringe to flush you need to draw back the syringe plunger with your saline connected to see if blood coming out thus telling you that you PICC  Line is in correct position,if no blood coming out stop and inform doctor may be your PICC line has migrated.

  • A majority of saline flush syringes are not sterile except for the tip and fluid path. Therefore, the nurse should not break the seal by pulling back on the plunger as this will cause the plunger to come in contact with the nonsterile area of the inside of the barrel. The only time this method can be used is when the saline flush syringe is sterilized and inside a sterile package.