HEPARIN SODIUM

Heparin

Reviewed by Dr Carl Kuschel, Ana Kennedy (NS-ANP), and Dr George Chan (Haematology)

May 2005

Management of Heparin Administration

Description

Clear colourless solution 1000 units/ml in 1ml ampoules.
Clear colourless solution 10 units /ml in 5 ml ampoules.

Prescription

Flushing of UACs, UVCs, and longlines after insertion

Charted on prescription chart stating ml/dose.

Flushing of luered CVLs and longlines

Charted on prescription chart stating ml/dose.

Continuous infusions are charted on fluid chart giving:

amount to be added

base fluid, type and amount.

Administration

Flushes

Luered central venous catheters that are not in use are flushed every 72 hours with heparinised saline 10 units/ml.
UACs, UVCs, and longlines are primed with 0.9% NaCl prior to insertion, and after completion of the insertion procedure are flushed with 0.5-1.0ml of Heparin 10 units/ml.
Administer by slow IV injection.
Compatible with D5W, D10W, NS and IVN and Intralipid.
Incompatible with aminoglycoside antibiotics, erythromycin, vancomycin, phenytoin, lorazepam, hyaluronidase.

Volumetric Infusion Pump

Heparin is added to IV fluids as per Newborn services policies.

Observation and Documentation

Monitor for signs of bleeding.

Storage

Ampoules 10 units/ml and 1000 units/ml: Store at room temperature. Discard ampoule after use.
Heparinised saline infusion bag and tubing are changed every 48 hours.

Selected References

1	Monagle P. Chan A. Massicotte P. Chalmers E. Michelson AD. Antithrombotic therapy in children: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004;126(3 Suppl):645S-687S.
2	Manco-Johnson MJ. Diagnosis and management of thromboses in the perinatal period. SemPerinatol 1990; 14:393-402.
3	McDonald MM, Hathaway WE. Anticoagulant therapy by continuous heparinisation in newborn and older infants. J Pediatr 1982; 101:451-7.
4	Andrew M, Schmidt B. Use of heparin in newborn infants. Semin Thromb Hemost 1988; 14:28-32.