SALINE LOCK
Presented By
The
Wayne County Medical Control
Board
Health Emergency Medical Services Inc.
(Wayne County Medical Control Authority)
Rob Bruley, FF/AEMT-I/C
WCMCB Protocol Committee
SALINE LOCK TRAINING
• This presentation is intended to be used in
conjunction with training provided by an
instructor or veteran ALS crew.
• It should not be used as the sole training
program for new personnel or as a review
for veteran personnel.
THE SALINE
LOCK
A.K.A.
• Heparin Lock
• Buffalo Cap
The Big Questions
• WHY?
• WHEN?
WHY?
• To save money!
• The Saline Lock provides an effective and
cost efficient alternative to conventional IV
therapy in patients requiring precautionary
IV access.
• IV kits cost about $7.50.
• Saline lock kits cost about $3.50.
• Saline bags cost about $1.00.
• Currently in use in all 5 counties of the
region.
• They are here to stay so we might as well
get used to it.
WHEN?
• Indicated anytime an IV is started and would only run at a
TKO rate.
• Indicated as the second and third IV lines in MI and CVA
patients where some medications require multiple IV lines.
(Currently TPA)
• Makes it easier for extrication from upper and lower floors as
well as any cramped space that you are treating a patient in.
(Less likely to catch on something.)
What are these kits supposed to
contain?
IV START KIT
• 1 0.9% NaCl -500ml bag
• 1 IV tubing set with clave Y site or pre-pierced reseal
“Macrodrip” (10-15gtts/ml)
• 1 Extension set with twin clave Y sites or pre-pierced reseal
• 1 14g x 2 inch IV catheter
• 1 16g x 1 inch IV catheter
• 1 18g x 1.00 inch to 1.25 inch IV catheter
• 1 20g x 1.00 inch to 1.25 inch IV catheter
• 1 22g x 1.00 inch to 1.25 inch IV catheter
• 1 24g x 1.00 inch to 1.25 inch IV catheter
• 4 Alcohol Wipes
• 1 Blue pad (wrap contents)
• 1 Tourniquet (tied around the wrap)
• 1 Exterior label
SALINE LOCK KIT
• 1 30cc Sodium Chloride 0.9% (preservative free) Vial
• 2 18g x 1 inch to 1.25 inch IV catheter
• 2 20g x 1 inch to 1.25 inch IV catheter
• 4 Alcohol wipes
• 1 5ml Syringe
• 1 Needle 18g x 1.5 inch
• 1 Saline Lock
• 1 Blue Pad (wrap contents)
• 1 Tourniquet (tied around wrapped contents)
• 1 Exterior Label
FLUID
• 2 0.9% NaCl 1000ml bags with exterior
label
WHAT THEY LOOK LIKE
Clave Connections
(Used in Needle less systems such as ours)
Old Way New Way with the
Requires Needle Clave connector
Old Way New Way with the
Clave connector
SALINE LOCK
PROCEDURE
• Really no different than we are used to but without
the hassle of the IV solution bag, the primary IV
tubing or the extension tubing.
• Prepare the site in accordance with standard IV
technique.
THE PROCEDURE
• Prepare the 5ml
syringe/NS flush prior
to introducing the
catheter.
– Attach needle to
syringe and draw up
5cc’s N/S
THE PROCEDURE
• Remove needle and
dispose.
• Attach syringe to the
luer lock/clave
connector on the lock
device and flood the
lock with saline.
THE PROCEDURE
• Access the vein using
standard IV technique
THE PROCEDURE
• Attach the Saline Lock
device to the catheter hub.
• Inject the remaining
Saline and maintain
pressure on the syringe
plunger.
• Continue to maintain
positive pressure on the
syringe and disconnect
from the lock device.
THE PROCEDURE
• Watch for complications
• Secure using tape or other
commercially sold device
such as Venigaurd,
Tegaderm, etc. Take care
to leave the end of the
lock device accessible
should the need arise.
What If …
• The patient with a Saline Lock in place
shows signs and symptoms that require
more than two (2) medications or requires
fluid boluses?
– then you attach the solution bag with the IV
primary and extension tubing directly to the
clave connector on the lock device.
SIMPLE
