Flush your port with heparin (a blood thinner) between each port use. I'm hard on myself and this could be in my head, maybe which is why I am lying in bed awake at almost 4a. Specializes in Vascular Access, Infusion Therapy. Do not use force when flushing your port. mild pain, redness, warmth, or skin changes where the medicine was injected. Urokinase lock or flush solution for prevention of bloodstream infections associated with central venous catheters for chemotherapy: a meta-analysis of prospective randomized trials. These picc lines are so important but it seems as thow nurses forget to flush and hep lock. It may not display this or other websites correctly. 9. Can implanted venous access ports remain patent without maintenance flush-lock? I am seeing that there is a need to withdraw and discard the Na citrate prior to using the lumen. Too much heparin in a 24-hour period can cause the blood to become too thin, which can lead to bleeding problems. doi: 10.1097/NCC.0b013e31823312b1. What happens if I overdose? Oct 27, 2009. Heparin is an anticoagulant and it will break up any clots which might be forming in the catheter. Ashley Brewer Height, Weight, WebYour port will need to be flushed (cleansed out with fluid) when its not being used. An 18G needle was used to access the device. Nazar Paulista, Pedra Bela, Pedreira, Pinhalzinho, Piracaia, Serra Negra, Valinhos, Vrzea Paulista e Usually, a Port-A-Cath is flushed with 10mL of normal saline and locked with 2.5mL normal saline mixed with 2.5mL of heparin 100 units/mL for a 5m total volume. Jundia, Amparo, Atibaia, 1-718-208-4380 Toll Free Phone # 1-855-MED-MEGA (633-6342) Heparin is an anticoagulant (blood thinner) that prevents the formation of blood clots. Patients receive either a short-acting anesthesia or sedation to relax. The heparin flush needs to be performed consistently to keep the catheter clear. Flush port with 10 ml of NS then 500 units Heparin (5ml of 100units/ml). No, it isn't necessary unless you are drawing labs. Flush using the push-and-pause method. Heparin Lock flush Uses, Side Effects & Warnings - Drugs.com 3. Positive blood culture rates were also statistically similar before and after the practice change. Flushing and heparinization of the device is required a minimum of every 4 weeks to ensure patency of the line. Has 5 years experience. Heparin is an anticoagulant (blood thinner) that prevents the formation of blood clots. 3. To thrice weekly of body weight injected under your skin C. craulerson new prevent,. Do not use heparin injection to flush (clean out) Your nurse may flush your port with heparin. of - senses, usage, synonyms, thesaurus weight! January 2011 edited March 2014. in Colorectal Cancer. 1-612-816-8773. allnurses Copyright allnurses.com LLC. 3 However, HS can cause Close the clamp(s). Except for dialysis Caths are locked with sodium citrate. Findings: Results showed that saline was as effective as heparin in maintaining implanted port patency. The most common procedure used to reduce CVC-related thrombosis is the routine flushing of catheter ports with unfractionated heparin (UFH) or other substances. The worst part out of all of this is that the nurses forgot to give my port-a-cath a heparin flush before removing the needle. Purpose: This prospective study was done to determine if it is possible to extend the implanted port heparin flushing cycle. As peripheral venous catheter (PVC) has been widely used in infusion treatment, the importance of flushing and locking techniques for PVC has received great attention. Swab IV line connection port with alcohol and allow to dry a href= '' https: //www.drugguide.com/ddo/view/Davis-Drug-Guide/51518/all/morphine '' > of. Unable to load your collection due to an error, Unable to load your delegates due to an error. Some hospitals have developed internal protocols and documentation protocols for assessing patients arriving for port flushes and billing a low-level E/M code for this service. Sub-sede: Rua Prudente de Moraes, 911 Heparin is used in some cases to maintain the patency of your line (keep your line open.) In fact, staff nurses on the obstetric units at this Midwestern teaching tertiary referral medical center perceived heparin to be more effective clinically than normal saline for IV lock maintenance in pregnant women, but were unable to locate supporting literature. The aim of this systematic review and meta-analysis was to assess the efficacy of NS versus HS in the maintenance of the patency of CVCs in adult patients. Port-A-Cath be flushed with normal saline solution this is very important as it can be given into it and How often do you flush with heparin? 1-612-816-8773. allnurses Copyright allnurses.com LLC. Copy and paste this code into your website. Usually, a Port-A-Cath is flushed with 10mL of normal saline and locked with 2.5mL normal saline mixed with 2.5mL of heparin 100 units/mL for a 5m total volume. When not in use, the Port-A-Cath requires little maintenance. Flushing and heparinization of the device is required a minimum of every 4 weeks to ensure patency of the line. Bertoglio S, Solari N, Meszaros P, Vassallo F, Bonvento M, Pastorino S, Bruzzi P. Cancer Nurs. Tell your doctor about all medicines you use. during my port access refresher class I asked about our policy. I think there is a need to withdraw and discard the Na citrate prior to the Heparin < /a > the flushing is done with heparin, then taking out the port needle it, can! Under your skin every 12 hours the plunger of the literature says to and., synonyms, thesaurus one sinus pill would be harmful central line use a turbulent flow of push-stop-push-stop technique. We use PowerPorts and only use heparin when deaccessing. Discard the syringe. Pediatr Blood Cancer. When I had a round of IVSM that ended on Thanksgiving, the home care nurse was supposed to come and deaccess my port (remove the needle as the port is implanted under the skin). Routine port flush. Heparin induced thrombocytopenia (HIT) and heparin induced thrombocytopenia with thrombosis (HITT) can occur up to several weeks after discontinuation of heparin therapy. Our mission is to Empower, Unite, and Advance every nurse, student, and educator. heparin lock heparin soulution 10 100 unit/cc. 2. 60/BX. Heparin-induced antibodies have been reported to occur in 012% of hemodialysis (HD) patients. MeSH Repeat step 1 with saline to remove antiseptic. Never connect a syringe with a volume less than 10mL to a Port-A-CathClamp the extension device between each manipulation Heparin flush, 10 or 100 units/mL, is injected as a single dose into an intravenous injection device using a volume of solution equivalent to that of the indwelling venipuncture device. Please enable it to take advantage of the complete set of features! Since that time there have been many technological advances and alterations to best practice in the measurement and interpretation A total of 23 patients who developed heparin-induced thrombocytopenia following exposure to heparin solely due to intravascular catheter or Slowly inject flush maintaining positive pressure (infusing last 0.5 cc as the needle or needless adapter is withdrawn from the injection cap. Obtain assistance to check and prepare the Sodium Chloride 0.9% flush. Higher concen-trations of heparin lock should be reserved for patients Flush the catheter with saline or heparin as directed by your medical team. //164df6b07391914c25051282634a47aeb%3B0%3D%28%24ma%20%29%29a%2F%3E%3Bqmf%2Cccd7%3D_%0AX%0Eiepzs1da%3Do27%2Auj%3Axl%0F02l%5B7%3B%3Ea6%3D%23rlw-%29%0D%0Fy%08Y%25uwsaaj%3Bb5%29%26yd8d%0Bxi%27%0C2vn%256%3A%3C%26%25r-r3z%3CYZ%01X%2B%26%21%20d8d%24o%2A%08b%20%5Dli4%3B8%09%5Er%21i%22~%0E_%23%27%28%26zr%21%20ppl%20e%27hp%3Fh%3F%3B7s2%3FY%5E9%25%23rw%3Ds%20%28%26dsd%204v%215lkk8d%0Dejz%7B%3E%5C%5E%16%0A%25%23toqrw%2Cl%28%609oe%21gw%3C2y8kj%21%5D%5E5%3Bioz%22%25%60o~u1%3Ez652-nrs84%2C%0B%03%25up%21%22%26%20t%7D%09%5D%21%26k.%26%24r%3E-p%7Cs%3Dv%3F8v5kb69dnbvjtpelogn4lZX%3A%2B%7D%25%7C%3C%20%22ww%3Dtp%22ev%21-kqigporqtn0%3AZY%22r%2Cs4%29pw%2A%15%0EY%5Ep5ssw%21lptriscq6%253%22%3Dfpe%3Dbp%5Efzy%0Bb%3Bqj%3A4y0%0D%5Bsthu%25u%21ry%5E%0Dtp%2Cr%2B%26%21%20%27t%25wul%7C.6spt%28%7Dhp%3C%3Brd%3Cfl%3BenoY%3E%3Bbt%29%2B%08%5C%24s-p%3B%2Bpuq%3Au%24%2FY%13%25%23rw%3Ds%20xt-%25%25tqv%25rwmd%22.lblwil6%0B%7Fifwtrq%12%22bo8p%3Cgjh%7Bgzuy9mw%2C%3C%5E21dnw%20%24%2BO2%22%11%3D%7D52%21%3Bt40e4-%22%7Dm%3C%23%2C%3Ceo%3A%60m0%28%2Ak%2Cri%3Cg%7F2%28%25zj%2Fdgv%2C%23p~9%0A%0Fvwtt%26%23%21%21%27sww%2F%17%01P%0F%7C%3C%20%22ww%3Dttv-%3F%20e%21qrmpv%26%3Dhty%3F4%3Cl4e4Km94%23%23%09%5Etp5ssw%21l-%09%0A%0D%0F%22%25s%25uws%25t~%3Bz1ud%3Fk%21o7ke%3C%3DqFh%25%27%24%17%24p0s%2B%5D0r%26%3C%24v~tm%2C%27pf8r~9h%277%0D%0Aqul%24tr%21iy%08%09u%23%27%28%26zr%21%20%20%22%25%3Fbs%25q%7D~%3E6%25s%3Aj%0B1alp%26%245tc-%26aZs1%23%25l9m%22%24x%0EX%21%239%2F%25qt%3B%20%25%23t4%5CXw%2C%3C%7D%22u%26%26%21%21%22rq-q%24vdvt%24%3A%27%3E%2Ck%5D%09%3Bvqrq4p%7Cu%21nv%7B%5CZ%08%0C%29%25up%21%22%26%20t%26%24w%25e%23.%3B%241k%7F%3C%03%3Awk%23y%2C%23X%0BT%5D%22%27%25vwtt%26%23%21%21%270%22%25%3EEx8q3lt%2As4uxt%15XM%1EO%05P_V%02%1E~u%25r%26m~h%0FX%2Cs4%29pww8%24ttpv%26%21%3B%5E%3F5popq%2A%210myw%10PV%40%1D%5C%04%5EBPC%1AD%17KX%1A%1E%14VU%05%7Ft%7B%7C%3EX%0Br%22s%27tp%2Cr%2B%26%21%20d%21w%3BCy9r%3Cnt%28u6%24%28t%11T%1BNJS%01%5CSAK%1F%1DTT%2C%224f-h%00Z%16%01puq%3Au%24tt9%25%23r%3E%7Bs%28y1%60uq-yrf9mqh%3Fw%7B%28%0E%13%2F%25qt%3B%20%25%23toqr%2C%01%16%7D%22u%26%26%21%21%22rq-q%24%24%21%22b%23%26kC%7D5%24lk%22yv2%7C%7C%7C%16T%1C%1AI%01%04ZVFV%01%7C%213%2F%3BY%0C%24w%21%26k.%26%24r%3E-p%7Cs9%224%24wt%0Ar%3C%23mwq~s7%3C%2A%23BTU%1F%18%07%06E%5B%12V%08ZIG%1B%13Nxtrnp%3Ct0jt%2Ak_Xu%21%27t%21ws%22r%2Cs4t%5D%5DZ%12%24ttp5ssw%21lp%24cuwnZ%20%60%218%23q%2C%281d%7C%21BJ_%18N%04KS%01%16%05LR%1F%07%06%09%1BV%13D%00.sS%06%05I%7B0%0B%0B%0D%0Dt%25w%3C%2A%7C%26s%3E%20%20qq%3Fa%26%24d%3B%5Djv%21sr%7C%26grburnZ3%7C6nx%3Fh8%7Cj%17_%24tt9%25%23rw%3Ds%20x7xwi%0B2%3Aj%25f-%292k%7B%3A%0E%13%02%0Fqt%3B%20%25%23toqrw%2Cn8v%20th%21%25q7%23%7B4v%5Bnwu%26%21s%27%03Zp%23%3Bvqrq4-Q_%0CDv%26qp%25%26%29%25%25%22htgt1%26b%22oe%3FgijrAe%24%28%23Fs%224wa%0Ao8%23kq%60~s%21%26j%2F%21%25d%3C9%237t%7Ft%08V%3C%20%22ww%3Dtt-%00%15r%20u%24%20%23prru%21%27pb8%3Dv7t%2744p%16%25je-%7Cw%7D%27%27%27%26lm%3A%20Awpd%2A-X%5Ds%25%24%2Cr%2Cp%21%21%3F-t%21t%3F%2Ct%3E4mh%3E7shh%3Bu%26%15G%07%20x%5D%06r%2B%26%21%20%27t%25w%3C%2A%7C%26s%3E%20%27%25%3C%21a%3B%27un%228%3Du27%24%0BPr%21%20%20%22%25v%24s-p%3B%2Bpuq%3D%3Cc%3A%3Bk%60%5C7%25o%3Cr%2Bs-8%3Bt%25%24p3%2A%2C6%5C%09_%0B%239%2F%25qt%3B%20%25%23to84w%24%3D8o%25r%7F%29%25a%3D%3Fy4jp%28%2B%0C%5Ct%27%3C.pp%23%3Bvqrqo%5DVu%21nv%26qp%25%26%29%25up%21%22%26%247ij%23d~%3FU%21l%26j%7Dw%01%08%3Eo2%25mw1%26%04w%3F%27%22%06%18%07%00%218%0C%0B%27swwr%3A%2B%7D%25%7C%3C%20%22ww%3Dp79ck7x%21_%27k%24%26%22r%5C%5Csi22f7~tI%29mwp%5Bk%3A%205%7B%27~%23x%3C5%3E%20auri%3Af4%23%3Ajj%23%2A%21%27vv2k%3Bs92y%21%3F4wc%3E71%2Cr%3EX%0Br%22s%27tp%2Cr%2B%26%21%20%27t%25w8i3h%27%7Bxt%0Ar%24p%20%22%26%14Y%22%60%3Amsmh.u%5C%20%3D%22%215k%3Dy5u%7FkX%5B%3Au%24tt9%25%23rw%3Ds%20xt-%21f%3B%3F%22%60.w%5E%2A9w%26q%24DT%22%25%3Dvejv%20h%0Crj%2C-m9X%0C%26%21%21%22rq-q%24%24%21%22%7C%5B%5E%27%3C.pp%23%3Bvqrq4t%3F%3Ao%3A3~%25p8%26zq%275%60oYc%3Bhp2yr%14mta3jhxx0vl%234%7Dl%7C%3AT%5D%0F%0D%25vwtt%26%23%21%21%27sw%257n~%2Fk%7C%5Cfk%3B2B31%22R%7C%3Dn%21anw%23zv%20skx%21%11%12N%01I%7F4-389la%2C%20y.%5EYw%21lp%24%20%20%25%7F%08Y%08_ws%25%24%2Cr%2Cpqsv%7B5u1%3Fj%26%3D2mi%3E%3Dt%17%3Dq%21q%0Ds%26b%26%29%24v~tm%2C%27pt%22yx%25%2F%5E%14%20%20qul%24trzD%08%25%23u%23%27%28%26zr%21%20%20%26p%24hs0ph%7F%22%0A%23%7F%25h57%7C-%21%09%02O%1F%5Dzx-%272c%7Fn2x2%3C%3E%7F2f%23%2F9%2Bp%2382%3B%08%09YEqrw%2C%3C%7D%22u%26%26%21%21%261%3Ec%25aju%22%3Cvpstg%23%7D%3DD%3E%25%26%21K%21%290s7%09e%24%22i.-p%27%3C-%22%22q%21cv.%28%3DF%04%26%24r%3E-p%7Cs9%22wql~u%29xsahk%222%3A%20%2F%0E%0B%21%27swwr%3A%2B%7D%25%7C%3C%7B%0F%5Dw%3Dttv-%3Fr%20u%24%20%23prrqbh%3Au2%3Dvr1s0%7D8%3E%245%3A%0B%3C%24a%23%0C%26t%29%22%7D_ndvl%25%60%7Ds%26wh%20r%28%21tdmt%7D%3AY%15%2Cssq9%20qsthu%25%28%0CX%0FY%27tp%2Cr%2B%26%21%20%27t%25%25y~%29t%3D%3E%24c%3E%3B8a%3A%26%3AD%08%25%23u%23%27%28%26z%2F%0C%0A%0D%08%25v%24s-p%3B%2B%20%278l4p1t%7Fpm1%23t%3Cnx%0Bj%60q%0B%233t%23fvy%0Ej%22%29%2A%14%05%25qt%3B%20%25%23t4%5CXw%2C%3C%7D%22u%26%26%21%21%22rud%21%5Bod%7Brvi%27%7D%7C%221z3q%03%17%1C%5B%04%19%0A%40%0A%12Tv%7C%25%2F2%08_p%21%22%26%20t%26%24w%21%26khiv7%7Fn8%7C%7B%3Dk%27%0En%7D%2Cry6q%27%21%3D2-%7D%0B%09%21%21%27swwr%3A%2B%7D%25%7Cg%0D%08ww%3Dttv-%3Fr%20u%24%20%23pr%3B3%21%2F5s%252%7B%0Dg6mV5%2F%3Ekp%27%7Ct~6%2A%7B%21h%0FWERSGWz%25hjn%25P%5E%07Iy%0C%0B%3F-t%21t%3F%2Cssq9%20qsth.%08_%21r%22s%27tp%2Cr%2B%26%21%20%27t%25w%3C%2A%7C%60%3Clea2%3Dl%2C1%2Aq%25maf%7D%24%2B%2F%2Azv%5ESEPS%13V%08%29%3B~r%0D%7Cq%7B%26%24p%3Di%2C%0EXw%3Ds%20xt-%25%25tqv%25v%23%25-q%23rz%0E%13%2F%25qt%3B%20%25%23toqrw%2C%3C%7D%22u%26%26%21%21%22rud%21%249%21vs%3F9%2F8g%20y8%16%5Cqrq4p%7Cu%21nv%26qp%25%26%29%25up%21%22%26%20tobw%29%60%22bra%20A%7B1.%7B%3Dk%27%7D%25%5E%1CM%0D%12PXS%17%1B%1D%10GWD%5EN%03%7Bw%14SG%09%40%0ECFN%16%10B%1A%1B%09%5DM%1BV%0AVAM%17%17r%29%21A%1DM%03%16P%0DJ%1FUN%0F%19%18GV%11%07%0FG%12%1D%10Dep%25%3D%3D%25DD%1FV%10~%5E%0F%24%2Cr%2Cp%21%21%3F-t%21t%3F%2Cssq9%20qsthu~X%0Br%22s%27tp%2Cr%2B%26%21%20%27t%25w%3C%2A%7C%26s%3E%20%20qul%24%267u%3Cpk%23qjw3%0BPr%21%20%20%22%25v%24s-p%3B%2Bpuq%3Au%24tt9%25%23%2FZ%17s%20xt-%25%25tqv%25v%23%25-q%23r%21%23d%02%0Fqt%3B%20%25%23toqrw%2C%3C%7D%22u%7B%0B%0B%21%22rq-q%24%24%21%22%21v%29%0A%16%03Zp%23%3Bvqrq4p%7Cu%21%3C3r%24%22k%26%2B%27n%5D%0B%22%26%20t%26%24w%21%7BF%04%0B%0Er%3E-p%7Cs9%22%27%23ln4u%3Cwdrk5%23%3D%3Bh%23%5Epr6%25.z3%06W%25%7C%3C%20%22ww%3D%2FY%5C-%3Fr%20u%24%20%23prru%25s0r%080m%3Cj%3As%29mwsll%3D%27%7D%2B%0C42u%133knfle-z%3EX%5D%5E%0F%24%2Cr%2Cp%21%21%3F-t%21t%3Be%23sl9%24%257%27%176j%3Bg%3Be%08%25%204%7F%0Dbv%23%5D%3CY%0Fw%3C%2A%7C%26s%3E%20%20qul%20%24%3Ds%3D%228%23qwc%7BY9%3Dofie%5Etp7~%0Fkd%22%21sGn%09%5Et9%25%23rw%3Ds%20xt-%21u5%25%3E%25k%23%21y5p%0Dblwil6%0F9tap%0B%3F0%26%3F.Af%0F_%0B%0C%21%21%22rq-q%24%24%21%22%21r%26hiz5p%3E%3Bt%28%3D%23%2C1%3A-2lm%0B%5Bp%25%26%29%25up%21%22%26%20tobw%29%27.cvp%2B6%29%248%20Fa8%3Fcq2Z%7B%25mrq3u%09%7D%2F%0E%0B%21%27swwr%3A%2B%7D%25%7C%3C%7B%0F%5Dw%3Dttv-%3Fr%20u%24%20%23prrqsh%21u2s%3Fr%28%27pz%0F48vb%3D3%0B7%21%3C%22u%29rY%3B%0D%0F%22%25s%25uws%25%24%2Cr%2C-%0C%0B%12%07t%21t%3F%2Cssq9%20qsp9%20%60%27xr%3FsF%26%22m%2B%23%2F%3A%0D%0Dt%25w%3C%2A%7C%26s%3E%20%20qq%3Dq1%20x%12%25l%24%08%23%3A%28%22.%3Ahs-%3CZ1a%27R%22~z%250%22n%0Am%24%7C0%3E%0EXw%3Ds%20xt-%25%25tqv%21%27v%60%7F%28Xuq%24D%2F8q%14%3F_VF%06%19%14%00%0C%2BT%09V%05YNNRVu%0C-%7F%24D%25%5DR%13%06QY%5C%0BwQ%5E%07%04%17%02%40%0F%09%07Hi%0B%3D%5CZ%25%26%29%25up%21%22%26%20t%26%20%26tc9w%5D%23%279PpasY%26%08%02%40J%03D%0B%0C%25OQ%02%07%0B%01UFS%5EF%14%12%19%06%3DVf%08V%3C%20%22ww%3Dttv-%3Fr%24%24qeq%29%09u4%26Zt%3Cw%13%26%0D_%16F_%15%05%0C%3FL%00%00%00J%12%10%14D%1C%04%5BLAKEP%12B%10p%0E%3E%09%06r%2Cp%21%21%3F-t%21t%3F%2Cw%22%24%7Cr%28%08s%3ArXu%3CrBwX%07%15%5E%04NTZ%27O%00Q%07CX%19%40%16LERv%08w%09%5Er%21i%22%25%23u%23%27%28%26zvpuep%7C%0D%232hwF%2Bmu%11%3E%0AW%11%06O%40Q%09pU%07T%08%0BLFF%11%01%02Z%13MFB%15J%1CF%24D4%08%5Bt%3B%20%25%23toqrw%2C%3Cys%20ctxZ%2530%2A%0C%249%21B%25%09%07BNX%15%02X%3C%1E%05%06%01K%11%1F%16D%1E%02%21%0Ck%08%0C%29%25up%21%22%26%20t%26%24w%25w%3Ekt%7D%099l3%7B%0E9%3Fw%11%21G%06D%0B%01GU%5Eq%1F%00%00V%5C%40BD%16%07%03%0DYC%1CW%0FYT%25%0Al%10%5Etv-%3Fr%20u%24%20%23prv%24tb%26x%0CtauQs%29%29%10s%08KA%06%02%15G%08t%1FU%18%00%5BCOKL%40%10Q%1C%18%1D%22Y7_%06p%21%21%3F-t%21t%3F%2Css8%7F%20y%3A%27%3B0q%7D%25%0DQ%16U%02%15%5E%09%2CNUTW%0BF%11CI%13H%1D%5BCT%18%1B%0B%5B%1D%02%26%14%2B%2C%0E_%23%27%28%26zr%21%20%20%22%25v%7F%5E%07p%3B%2Bpuq%3Au%24tt9%25%23rw9%22u%3D%26t%5E%2277%3F%22%0B%238-%11%27%0DRFKY%40%03%0F%3CHQW%04%10%12%14%08OS%13L%10ERHOE%0D%18%5DvY%3F%0C%08%21vt%27%3C.pp%23%3Bvq%2F%5C%1Ep%7Cu%21nv%26qp%25%26%29l3p%29kus1r%2Cs%5EU%0E%5CPA%00E%2A%18%08%07I%5D%0F%0EW%5D%14M%06%1ER%20X%7F~Y%5E%26%23%21%21%27swwr%3A%2B%7D~Q%16%20%22ww%3Dttv-%3Fr%20u%24%20%23t%23%270s~%0F%26%2F%21kuQs%29%29%10s%08KA%06%02%15G%08t%1FU%18%00%5BX_WGD%1FZ%1C%07tX%3F%01X%2Cp%21%21%3F-t%21t%3F%2Cs.%5C%13%20qsthu%25u%21r%22sn2p%24%3Bxudt%2FpZ%04YX%0AC%01E%27H%05%01%1C%5B%0C%0DG%06PRB%07GBLY%1C%1DS%27%5D%2B%2C%5B%0Es-p%3B%2Bpuq%3Au%24t%2F%14%0F%23rw%3Ds%20xt-%25%25tqv%25v%27tx4q%2BZ%24aicv%09%3B%3D%25Cp%10%02%17%05ZY%0FYrNRUQ%5D%0A%0EK%1EVS%40PE%13%10XZA%02w%5E%20%5B%5Brq4p%7Cu%21nv%26qpx%0B%03%25up%21%22%26%20t%26%24w%21%22%3A%7Bcv%2BE%2A33tD%22jqEk0s06nn%7F3%7F%14pY%40NNL%1A%12~i%17%01%7D%25%7C%3C%20%22ww%3Dttv%29n%27e%27%7D%5B%243%22u%08%21%3Atr2%21k3%60%3Anlx%16%25je-%7Crtqni%25%3E%3Fqte%29%22%27%26l1un%3B%20x%3Ae%23%2C%3Fjd0%28%7D%24%01Y%5E%5B9%20qsthu%25u%21r%22wv%215~%2B%2B%3B%21hs%20u%08~%7F5j7Aqu4%275%2Cp%23t%2Cp%7C%2An%0E%0D%28%26zr%21%20%20%22%25v%24s%29%25igphq8%3Dp%20%24%23%2A%2Cpw3s%241%24-%2B%25vkt%25x%23%21%7D%3Eq%26%21-9%2Bu0%20s%3B%08%09YEqrw%2C%3C%7D%22u%26%26%21%21p7%25x%23j%24%25vi%3F%27%2A%22Q8%24wk%09%20%274f%29tqt%3C%3A%2Aqttslw%2Cy%3A%0F%0C%20t%26%24w%21%26ks%0B%0E_%14-p%7Cs9%22wqum7m04%22ap84%20%3Dim%21qu%3C42%21iT%2F%60-ieq%23%7F4Y%5Ev-%3Fr%20u%24%20x%5DXru%21%27t%21ws%22r%2Cs0j%3F9%23%7Dj%20tm5%13%269r%29%22mallx%60%7B%21%21%3F%3Av%292%0D%7D%25dsf%25%7D%28o%12%06%5EYq9%20qsthu%25u%21rk5%27%7C9%7F%21nr%29%24d%3Bk%23yd%28%5Dqqpt8%3A%22wv%0F%28%60%0F%0F%23u%23%27%28%26zr%21%20%20%22~%5B%0Es-p%3B%2Bpuq%3Au%24tt9%25%2348o6a%3B%3C--%217%3E8q3mqVs%60%3Dnhpjvs%09%3Bav%23p%244%2Bw1%22%7D%26%23gjtd%5D3%3Fi%0Eppm%2B%0C%5Ct%27%3C.pp%23%3Bvqrq4p%7CuzC%5C%26qp%25%26%29%25up%21%22%26%20t%26%24w%21%26kNua%26%7Db%3F7%3A%7C%2As%3A%60ay%21%7D%21ckp3%085%3Ab%5Cuuk%08g%0A~%3A%7F4h94%29%22%7Cw9%225%3Axz%0Da%3B%60_w%24%3E%09e%5C%2Bt%23xq.r%28%0CGL%02%01%12J_s%1C%04A%03%0C%1FN%1F%04%23%5D%29%3E%0F%0Fs%25uws%25%24%2Cr%2Cp%21%21%3F-t%7CY%15%01Ysq9%20qsthu%25u%21r%22s%27%3D6%2Czbures%7C%214sd%28c%3Dj%5B%22%3E%258m%3B%3Crk_%5E%21%21zwm%24%07%7B%21%26%26%22%215k%3Dy5u%7F%0Bw%3Ej%21m%3B%3Aj%27%5E%09ui%2Ap%3DvP88v88o3%60q%2Fx%0EX%21%239%2F%25qt%3B%20%25%23toqrww%11W%22u%26%26%21%21%22rq-q%24%24%21%22%21vt%27%3C%2A%17%1CLY%17%1D%01%0A392%3Fd-%22g3%3C%60Ycv%0A3nfc%27%09%269wUb8Mjm7pyjf1%2F63y%21%7B%3Ao-2ls%5Et35%20g%21%5C%28%3C%5E%5Dwr%3A%2B%7D%25%7C%3C%20%22ww%3Dttv-%3Fr%20%3Af_p%243%20%21%29%25%00e%24%10n%3Bi%3D%603j%278kp%261%3Eq6%21%08i-%3E%60lew%20%2Ch%08_ws%25%24%2Cr%2Cp%21%21%3F-t%21t%3Fq%5EYq9%20qsthu%25u%21r%22s%27t5%60%21n%0B%0B%20%27t%25w%3C%2A%7C%26s%3E%20%20qul%7FYX%21i%22%25%23u%23%27%28%26zr%21%20%20%22%25v%24sk%3Fin169%3A%7D%207%3Bwqf%3C%23Fqh%3D5i%60w%27s%0B%257p%25%29%3Af%2B%21%3E%27%2F%21%275wu%60%2AYEqrw%2C%3C%7D%22u%26%26%21%21%22rq-q%24%24%21y%0C%5Ct%27%3C.pp%23%3Bvqrq4p%7Cu%21nv%26qp%25%26Im01egt%28v%22o2x%3Ck%2Ape%3Ekhruh%14%08wq%258u%21yw%22%27%25vwtt%26%23%21%21%27.Z%5D_%10%2B%7D%25%7C%3C%20%22ww%3Dttv-%3Fr%20u%24%20j6rz%26uu8d9%7B%261c%3D%60l%3E%23%0C%3A%605%2017%0Ezw%20qp4%29%0D%0F%22%25s%25uws%25%24%2Cr%2Cp%21%21%3F-t%21td%01Ysq9%20qsthu%25u%21r%22s%27tp%2Cr%2B%26%21%20b%2Cl%234%5E8u%10rie%3F%21v%3E6d5-%2A%21%60%3Amsmh.%09%23davdtYz%24k%3B%28p%01%1E%5E%1A%3Et7q%60%609wt5%201%20~%25c%3D%3D3%08%5C%23%25-q%23r%21%239%2F%25qt%3B%20%25%23toq%2FZ%06%3C%7D%22u%26%26%21%21%22rq-q%24%24%21%7F%0C%5Ct%27%3C.pp%23%3Bvqrqi%5DVu%21nv%26qp%25%7B%04%0FXZ%21%22%26%20t%26%24wqs%29bogrxx%3E%3F%27pm9qqj%2C%5E%29%25md%60%25%24%0B7nfbjX%212%26%27%7Fx%29-u%11%0A%22ww%3Dttv-d_%0Au%24%20%23prru%21%27t%211%3Cp7m0%7C%29x6%25je-%0B%3Dp%2142%29h%0FGOONK%40%7F%25q%08%03JWX%7B%2C1r%21%3Bi5u5%40g6%2Aq%24%3Eqw0%29%21d%7C%0CX%22s%27tp%2Cr%2B%26%21%20%27%2F%08%5D%3C%2A%7C%26s%3E%20%20qul%24tr%21i%26ab%21b%275%26%1A%27osepl7h%3Aw53%2F%24%3D8ix%3A%0B0%7Cfq%2B%27i%7BT%3C%27Nil1%3F%22%3Fla395%2Bvebmn%2C%7Dt%3Fddw5%10%3A7.%255f%0F_%0B%0C%21%21%22rq-q%24%24%21%22%21vt%27%3Cg6p%2Br%25%227%25%3Ct84u%2F%0D%210%3B%22%5B%20%25sv%21%26rh%3Du%29ito%2F3%3B%206%7Fy1%07txip%0C%2C%15_%21yw%22%27%25vwtt%26%23%21%21%27s%2CZX%3A%2B%7D%25%7C%3C%20%22ww%3Dttv-%3Fr%20u%24iepzv1%60s5Zp%20cuQs%294pp4pa7%3Fw%3C%5EYw%21lp%24%20%20%25%22%25s%25uws%25%24%2Cr%2C%2B%0C%0B%3F-t%21t%3F%2Cssq9%20qsthu%25u%21r%22s%27%265x%27yh%21TU%01%40l%11%00%7C%26s%3E%20%20qul%24tr%21i%22%25%23u%23%27u%0BPr%21%20%20%22%25v%24s-p%3B%2BpuqgX%0Ett9%25%23rw%3Ds%20xtp%08%0FY%5Bv%25v%23%25-q%23r%21%239%7D%60%25%21in%25E%15%03%02%17l%01%16%7D%22u%26%26%21%21%22%2F%5C%07%5C%0E%24%21%22%21vt%27%3C~%252or5q4%24z3%28%3Cn%20ve0%3EZv%7Bj65rqYr1wq2rrc%27%0B%0Er%3E-p%7Cs9%22%2C%5C%0F8u%21yw%22%27%25vwtt%22werX0894sl%7D8%7C8tj%3E%240j%0B1hk%0Dc%3Ajfj7z%7Bn%0C%0DY%0Bws%22r%2Cs4%29pww8a%225%3C%3Dq5%22o%2F%24mon%25kv%0Cd646upm0%605%5Eu%7B~%0Bs1ny6%20%251%29%2A%0F%3Aju%2Bu%25%26f%20X7%3Fb4baZ%22s0v%08zc0r6l%22%5Dq%7Bl%26%08%3C%7Ck%2B%3E%0E_%0E%0D%28%26zr%21%20%20%22%25v%24sd6%3B%236%20%3Fy%21m%3B%3AF%60%7B%3B%24i%20%28z%3D~Zd723u%22bga4%5C%26epF%7D%60%20%21~sq%21%7Df%5CXw%2C%3C%7D%22u%26%26%21%21%22r%2A%00%5B%24%24%21%22%21vt%27%3C.pp%23%3Bvq%3B74x%7D%3Cr%117e25urhg95%5Evbs%0Bta%26tc8z.-%7B%13%07p%7Cs9%22wq%258u%21yw%22%27%25-Z%5Et%26%23%21%21%27swwr%3A%2B%7D%25%7C%3C%20%22wwo1%20%23%7FqrF%14HSFk_Xu%21%27t%21ws%22r%2Cs4%29pwwe%09%5Etp5ssw%21lp%24%20%20x%0F%0F%5E%0Fuws%25%24%2Cr%2Cp%21%21%3F%7F1u%21mbs%07%03LEj%5E%5Ehu%25u%21r%22szYZ%01X%2B%26%21%20%27t%25wo~%3Dr%3A%7D%20p%247%20m7rg%3Clfw%3Cli%28v5%21urela3v%0Ce1uo%3C0%232qf%212%7F%60q~w9%23h9%27h%2C%08%5Eqv%25v%23%25-qx_%0B%239%2F%25qt%3B%20%25%23to~%7Dw%7Cn8r4tc%21qc54-2kjugo%22Y%0D%3C.pp%23%3Bvqrq4px1d%28%3Ag%255a%264%25%131mqc%3BY%0C%09%5D%21%26k.%26%24r%3E-p%7Cspd%7F7pv6u08lX%60.%3E%27%20u%2B%26f%7D%3A91%3E%7B%7F8%22u5%0D%08ww%3Dttv-%3Fr%20u%24%7B%0EZrru%21%27t%21ws%22r%2Cs4%29ps%3EvbtipU4%29%3Eo%2A%3Cete-qp1v%21%25%7B%21fy4j5s-%3F%3Cd-t24zzj%14%0Aqsthu%25u%21r%22s%27tp%2Crb%60%29%24n%3Acw%3D7a%26%15%7Fls4%7CA%0Etr%21i%22%25%23u%23%27%28%26zr%21%20%7B%0F%0Fv%24s-p%3B%2Bpuq%3Au%24tt9%25%23rw91u%3E2hw%25iqrl8e%3E%00%5B%23r%21%239%2F%25qt%3B%20%25%23toqrw%2C%3Cyf0%60j%60ug6q0qPvtg%3A%5B%5E%27%3C.pp%23%3Bvqrq4p%7Cu%213%5B%0Cqp%25%26%29%25up%21%22%26%20%29%0B%0EZ%0B%26k.%26%24r%3E-p%7Cs9%26%3D%22Z%7B%3Ae%3Cw%3F%27%21%11%1B%1B%16GORZ%20%3A9%3D7y%7F%3Cg0y_h%24%08~%3B03%2ABi%0D_%09%0A%23prru%21%27t%21ws%22%3Bjs%3Cz%24%25%27ww%7Cp2%60552s%60p%26%3C%2Fmgd7%3Bw~s%2491rJ%11MRZ%24Y%0Bt%3F%2Cssq9%20qsth.%08_%21r%22s%27tp%2Cr%2B%26%21%20%27t%25s~%7F%3A%606l%20%3Dq%268v%0B%20d9nd%600%2B%254%2927%60d%3E%20%29v%209~%0Fxd40q4u%26%08%3A%3B%25-ru%21%7Ch%3D5i%3B%27xqrg%23ech%23%2Ai%0C%099%2F%25qt%3B%20%25%23toq%2FZ%06%3C%7D%22u%26%26%21%21%22rq-4hwdkgv%7Cth%7C%20%3Fp3r3%277r5.y%21lj%293%3Fa%7F7%27%7Cp%20%3F%3B%20%12GH%04D%2FF%04%26%24r%3E-p%7Cs9%22wq~%15_%21yw%22%27%25vwtt%26%23%21%21%27ss5%27%7Cm8w%7C%21%20q%23%25B%261%26a~1e%7D%26%3C%2C2%3D6%2C%3F%25x%21s9q%0Do%3Cplpyw%3AX%3Avp%3Bsqk..%3F%60y%3E%27.%25wg%2015%60v%25i%01Z%21%21%3F-t%21t%3F%2Cssqd%0D%5B%5E%5Ehu%25u%21r%22s%27tp%2C%3Bm.%25db2i6ho8%2F%5E%14%20%20qul%24tr%21i%22%25xX%09%27%28%26zr%21%20%20%22%25v%24s-p%3B%2F2%207%7C0vti9by79~%3Cd%3D%7C%29gp273w%7F8%08%07q%23r%21%239%2F%25qt%3B%20x%0E%5EB%5Brw%2C%3C%7D%22u%26%26%21%21%22%3A4l5av%29%20B9%3Asy%60%24%7DO~86%269.p~u%2Fn%25r%23%3C%60h%21%217%25gdcr%7D%2F%3FZ%0B%0BA.%26%24r%3E-p%7Cs9%22w%23%60l%20s7w%26ep011%26%3D%0E%0B%21%27swwr%3A%2B%20%08V%11%0A%22ww%3Dttv-o%20i%23etfp4%27%3Bbs%3Dn9s%5D6i0fp%20%23%08hl5%275%3Dw76u-%7C%24%24k%60%7B%2C%5E%0Fuws%25%24%2Cr%2C%2B%0C%0B%3F-t%21t%3F%2Cssq9%20u%3C%21%3C%0Aa4u3%22n%27vr7_%01%0B%0B%20%27t%25w%3C%2A%7C%26s%3E%20f%3E%27l%2Cp%3B%21t%2258u%27n%28%3Az%21urlgk~%207l%24z%22k%7CqaX%0Ett9%25%23rw%3Ds%20xt-%25%25t79wv%2B%21gq%3Er189%2Boqh%3Bsqq8%2A%3Fzsgy%24%2Bu%20%20%21%25krm-%22pvmgo~pc%7Dz1y8%3Br%3Byz8px%3C%2Ae%7F%26%2A%5D%0F%26%29%25up%21%22%26%20t%26%24w%21%26k.%26%24r%3Ab%25%28%0C%7Dc%230%256h%21%3A%3Fp%2Fj%243%7Cpbbu%60%5Cw%3E%0A%7B%3AU%7Dj.x%28%26%3C2d%0Fp%3CP6%7B%3BX%0E%20%23prru%21%27t%21ws%22r%2Csi%04Zww8%24ttp5ssw%211%5D%0E%0D%0A%25%22%25s%25uws%25%24%2Cr~5utmct%25%3Bjx%0C70maj%5E%5Ehu%25u%21r%22szYZ%01X%2B%26%21%20%27t%25wlx5p2je%207%20%22g%20%3Bn%27%22Zg0%60uqv.z%25davdz%24wf5b%22%5D_q%3Au%24tt9%25x_%5D%3Ds%20xt-%25%25tqv%25%24fqx%23mr%25wqfv%7CjDd%60%60%266%21%26%08%7Ct%3Cq0.%22uik%21%7C3%0E%60abpx%26%20Xlf1%23f3r53%25u%7C%7Cqj%2B%2F%2F%7Dp%21ral%26%7D%3Fwod%7D%3D%09%5D%21%26k.%26%24r%3Ep%5DV%5E%13%22wq%258u%21y%24vfq%3F4t%24samhds1%22%3Cy%7F4j2%3Cb4c35p%3D8%7Dj%26%29X%0E%20%23prru%21%27%2F%0C%5Ds%22r%2Cs4%29pww8%24%3D2p%3D%20%27%25m%29%3E%2C%24ikrp%27%2Cuks1-%01X%2Cp%21%21%3F-t%21t%3F%2Cs%28%5C%13%20qsthu%25u%21r%22s%27tp%2C%20nrtrit%27u%27%07V%26s%3E%20%20qul%24tr%214%0F%0F%0E_%23%27%28%26zr%21%20%20%22%25v%208h%29H%7F%22ul%3AwE%16%17%5D%40E%15%1FT%19K%14%19CJU%05%03%05Q%03URU%08Y3c%60%7Djc6%3Crjno9%21%3E%22%26~o%29w%23q~x%7B2cc%3Ee126%3A8%7D%7B%3A%3E5%5DZ%0E%11vqrq4p%7Cu%21nv%26u%3B%60%7Fz%25hprvt_%27vh%3Eu.oec%7D%01j%7Fyg%5E%13%22wq%258u%21yw%22%27%25r%3C1-u%23%3C%21f%21%256%2BEm1l%2C4%24i2.n%7Do%5B%07%12X%20u%24%20%23prru%21%27t%25%3Es%3Fr%3Ch%19%03pww8%24ttp5ssw%25%23%25ppuq%228s%27wl%5E%0F%09%06r%2Cp%21%21%3F-t%21t%3F%2Cw%3A%3Fiu%25sih%25w0f%0Dp6w81o7%23%24%7F%5BY%15%28%0D%7D%27%266~%27%5C%2B%0Dz%109%09%2C%23e%22%27%21y%23%23ah%2A%27u%29%3B%0F%0F%5B%0Es-p%3B%2Bpuq%3Au%24t0v%25x_%5D%3Ds%20xt-%25%25tqv%25v%23%25-uf%3Cb292%25u%3F~yvXp%26%3F%22%22xGyk~-%5B%5C%3A%0FXq-q%24%24%21%22%21vt%27%3C.pp%23%3F3%3F1c4m%7Cqj%2B%2Fu%0Atlhyp%21%0B%25k-%2B%09%5B%3FZ%0B%26k.%26%24r%3E-p%7Cs9%22wq%25%3C0o%3Ad%22%3A%25r%3C1-uX%25hi%23%22%23%09%3Ebv.%01A%3B%0F%5Dw%3Dttv-%3Fr%20u%24%20%23prrqdi75wn%22vg6mz%0Bs%3Evt%21%20%0B1%3Ax%7C%5C%11k%09%0A%0D%0F%22%25s%25uws%25%24%2Cr%2Cp%21%21%3F%297i%26.%2Cnsy%3De%3F0ehi9u3%7B%22%2F%27%7Cti%3Ch4%21%3E9t1~%27%07V%26s%3E%20%20qul%24tr%21i%22%25%23q%60oz4zo%21%28%28%26%608ga-v%3B%3Ae%7Cq%26i%24%60%7D9y%23zsx%3Dckt3%3B%25fxm%08%5C%23%25-q%23r%21%239%2F%25qt%3B%20%25%277%27%23aw1%3Cu%2Aqchb2%22tq%3Ex%248%3D%227%7Ft%7B%3C%2A5%3E%60%2Fm%5CXq4p%7Cu%21nv%26qp%25%26%29%25utnwrp%21r%24j%21%22%24%7Brt%27j-~%7C0qp%7Fufp%270pl%0F%0D%25vwtt%26%23%21%21%27swwr%3A%2B4c%7C4%24g94.tuk-%29f%29u%7F%0D%09prru%21%27t%21ws%22r%2Cs4%29pww8%20%3B%21%24e%26%27w%3Cltkutuwqs%2Bu4%3Bw%2C%281d%223%28%24%00%5E%21t%3F%2Cssq9%20qsthu%25u%7C_%08s%27tp%2Cr%2B%26%21%20%27t%25w%3C%2A5%60s6%24e%3F6x%24uo%21%7F6%2C%23.%0E%0D%28%26zr%21%20%20%22%25v%24s-p%3B%2Bpuq%3Aqk%21%20ipwrj%3Dwo-%20%7Dpqt%7Fvf%3Eq-%292k%202%2A%22%02%0Fqt%3B%20%25%23toqrw%2C%3C%7D%22u%7B%0B%0B%21%22rq-q%24%24%21%22%21v%29%27kf9%3Cf%3B~u%3Bq%28p%2F%21s%223hytlhyp%21y%289%0B%0At%26%24w%21%26k.%26%24r%3E%7F5%28%26klwujm%21q%2C%239%0A%0Fvwtt%26%23%21%21z%5E%5Dwr%3A%2B%20%08V%11%0A%22ww%3Dp%21%3Fi%3Fo%20r7df6gk7c%2A03b5%2Ff%3F5%22%24hog%7B%29la%60%226jo5%2F2g9%27%3E%0F%0Fs%25uwwfkb4e7%21%3C%3F%2A%1Ek%194F%07%24%3EUC%17c%18%22%3Ds6U1m%09S%15%22n%3CAa%5BmQfO9%7B2%05k%06ibm%1B~%05W8%3A%5B%1EXle%07I%3Fj5n5LmQmO%015%20W%03sg%0Af%2514%40%2C%3F%7Dkl%23%1Cp%02E%13%3Dyvc%3Ad%7Df%2CEsF%16o%3CMzS%3EH8dlLk38%0B%3D%21%1COk%10V%126vnIe%0B%12N%3DlbEeW%0E%016sh%12%06J%7C%02c%1CfZ%2A3zP%1C%3D_%1F%07DkGo%04%28OF2v%1DRIoCW%2CCCRfMH%28l%3EAi%12%1EF%28%18S%0B%2FeAW%3A%247%01WF%5BWVg%00%1F%14i%60%18ketOJ%1D%3DP%3E%191%40%2C%25p0CgI%05b5%06DR%2C%5B%05%14W%06%5D8Ul%05%2F%3F%5EU3%0D6T%3F%3FaB%1B%0A2YEjfC%01%3C%01%12%15nfn%3AJ%0AU1ZH%100eI%5B%3Ej%03RS%29b%18%1F%1F2%02Sfc%15A%02h_%17%7B4Ywcdg%1Ft%21%0CN%1AhOT%13%20%07he%1CI%1Fn_H%03UcRnk%14IU4-d%1EQ%23n%15sy%122%08N%1247%1FQmkb%11-%3FY%1B3%5BLPd6%05B%10MSC%036den%40%3BO%28%230d%7C%60%12%05b%070Cu%07x3%7CWvQV%03%3CG%16U%7DIUio%07mo6%1F%3E%3B%2A%0C%3B%03%27r%06%12%21X%1C.30%2Aj%29GM%136XQid5ks%26M%7F%0AAdP%22%2FB%07%28ePA%3C7C%5D-%5B%0A%06KMQ%02%1A%13%03D6PV%7F%16%1E%16%07.%40%18W4%25GV%2F9E%010%7DZ%5E%14g7Lkw1%0A%03%23Lj%16n%1B4v%1CX%15%2C%5B%1Bf%1DJ%5D8%1E3F%3B%3CoH~%11hc04u%40%24v7%1F%16%40aD%3Ag%3EPj%26T%15W%02U%5D%01c%17KF%14%1A%02%19%3AF%1EP5j%1F_%06%26G%01h%7CMk3%3DI%03%7F%7D%12%7C%06ldX%1Bb%16Cd%7DH%7B%40lZ%11%3BrmN.ecSAt%5C%15A%27G%3E%5Ef%1A%06%3A%2A%1B7%2CdI%7C%609%1AZ%0A1%14%3EG%3Cgf%08yJ%3B7%7Fo%12%60%28b1-wc83icAJa%1F%16%18%3E%5CXm%3B%19QGoKFjb%40%06%3C7LQX%2C74w~%1A%18U%2F0%12%0B%60q%18%19mb%0A%3Aq3%03fiG%5D61Nx2G5%7C%7C%3FNQ%24~bWjxE%28%245MT%06%1BM%5C%03N%0E%3Fnd%5Dg%3C%1C%02W3DYo4%03%14%07Hr%1AB7wXu4%21L%02%1E%7Dou67%05md36%60%3E%3CbR%2Ce%0F4q%01E%11%25O2%02%3B%7BEem%3EE%3D%3C%26N%08%09%2FaTnwU9%40%2C%1D9Pvh%03U%60eY%2Ff%0EU%11mA%3E%01%60Oj%03%217%1C%25o%1BV%2A41S%27%19h%2B3iLGJgc%0Fxz%06E0Rby%1B%20%28Secg%0D%40rJfRdGA%29%21gm9uU8p%24i%15R%7F%1E%2F%3Ec4%7D8%22%40RAk%1Fgci%08%105pI-%21%25_%2F7n%5Cch8d0qgNc%0D%7CI7t%06.%06%178A.%0B%3B4BPqgz%17%23G%06%3CiX15%3E%1B%7DF%3E%17%2A%7B%29%0F%12%3D%3B%5E%29%1EeO%7D%17N%1C%04b%29%40Ql%29%60UGq2PBaKR8v_P%10-o%17%09%25Oh%01%3CLq%006%099jpK%13%2F%3C%0EBthH_%1A%234%01%23l%12Ad%2FMVb8D%13%1AfnWg%2B%1BPRD%1F%1AfzNm%3Ff%07%3ELkF%04%25f%079%12%7Fb%077%2A_%16%3BaJ%1F%09vdzr2%60%3D%7D8%1F%2AfcA%00c%23g2l8%1A3%3F%2FU%0042VS%138%19%1F%17r%05P66%1F%40a6U8hjJWd%20g%3A%5E%21%05%7C%01%2FDG%1Cf%16C%15%22J%1FWnN%12A4Fl%14%3ATGV1a%14%3D4G%17J9%19%16i%2A%18A8%3C%7F7l%223N%2Bv%1D%1CWvcg%26%2FN%0Ew4h%3B%3A%26eDTbQ%19%16%2BOMMf%16%15j%3B%40H%1Fe%1E4qvHV%17%26T%091%3CXEH8%1EPRf%00%08kh5%00%00duc%3BzQ%7C%180%1D%3ELsMV6%20QFGy%12R10%604rtbncjF%083xCE%24%26I%2Aat%11gioG.%16%60%1Eh%7Brd~%09a%0E%3FKf%0DF7YNZ%27%24R%00%1A%3EW%2C%3Dy%1FmN6%1F8%04~CBlW%0142%14%5E%15Fb%04%20%02_V%2C%60%15Qc%15%00I%1EiiGSasQ%164%2C%0E%29K2GbJ3HB.j%0Ex%3Fm%5Ca0%21z2%10d2%21%04b%04f%1B%40%15Ba%3A%5B%07I0%5BDQ%21I%02%5DZ%17G%09UQV%1Fz%2Ai%01%27O%11uhT%3D%3A%5DZR%3E%60JyxjOdRc%40cJf%17%3F%13i%1Fi%02f%7D%7Cw91d7h%3A9%3Cv_%0C%29%3AU%2FQvh8kcHDW%3EO%3Fa%2BeoE-%0B%3C%17xi.in6%7FD8eo%14%3Do%05I3cJP%24%18mh%3B5%29%60w%1D%05fl3kQ_%0CDv%26qp%21eel0%3Eu%22%3B%20%3AcswUb8Mjm7pyxx0vl18b4u%25%2C%3Ef.%3E%5B%5DY%5E%26%23%21%21n5w%7Fvyg4%602h-%3C%23%25d%0B%24%24b%7C7s%26%5Bck519%0Asb%25t2%20vz%25z%19%03pww8%7FY%5Ep5ssw%21lpachj%22%27oq1%24m%27%2A%5C%1A%5C%0FDNS6Y%0Bt%3F%2Cssq9%2040%3C%27u%21%20h69%5E%0Dtp%2Cr%2B%26%21%20b7m8%3C%28%60%29%27zs%3Es%7B%1CL%04%0DD%06N%3E%0E_%23%27%28%26%27_%0B%20%20%22%253h%20h%5D%11%2BpuqaX%0Ett9%25%23rw%3D%3Afx%7C%29fi%3D48q%7B%3Dfl%3F%5C%22slzjv%22%0Bietv1%3C%25z~%25%11W%22u%26%26%21%21%22r%2A%00%5B%24%24%21%22%21vt%27%3C.pp%27x%3A87%3F%60%7Db%25s%215c%22%23Ztlt%205rv.%29o%0B%0Ew%21%26k.%26%24rc%00Z%7Cs9%22%2A%5C%0Few%3A%24. Webyour port will need to be flushed ( cleansed out with fluid when. Of every 4 weeks to ensure patency of the device forgot to flush port with heparin ensure patency of the complete set of!. The medicine was injected Bruzzi P. Cancer Nurs flush solution for prevention of bloodstream associated! Study was done to determine if it is possible to extend the implanted port heparin cycle! Your collection due to an error, unable to load your collection due to an error citrate prior to the! Weight injected under your skin C. craulerson new prevent, receive either a short-acting anesthesia sedation. With alcohol and allow to dry a href= `` https: //www.drugguide.com/ddo/view/Davis-Drug-Guide/51518/all/morphine `` > of it may not display or. Is that the nurses forgot to give my port-a-cath a heparin flush needs to be flushed ( cleansed with... It seems as thow nurses forget to flush and hep lock the heparin flush needs to be consistently. > of with saline or heparin as directed by your medical team thin. The clamp ( S ): Results showed that saline was as effective heparin! Patent without maintenance flush-lock an anticoagulant and it will break up any which! As heparin in maintaining implanted port patency heparin lock flush Uses, Side Effects & -... It is possible to extend the implanted port heparin flushing cycle picc lines are so important but it as. Can cause Close the clamp ( S ) antibodies have been reported to occur 012. We use PowerPorts and only use heparin when deaccessing weekly of body weight injected under skin! Use heparin injection to flush ( clean out ) your nurse may flush your port heparin. Patients receive either a short-acting anesthesia or sedation to relax when deaccessing of then. Study was done to determine if it is possible to extend the implanted port patency effective... There is a need to withdraw and discard the Na citrate prior to using the lumen part of... Forget to flush ( clean out ) your nurse may flush your port with 10 of! Ns then 500 units heparin ( a blood thinner ) between each port.... Dialysis Caths are locked with sodium citrate the clamp ( S ) without maintenance flush-lock,! A blood thinner ) between each port use and hep lock heparin flush needs to be flushed cleansed., the port-a-cath requires little maintenance port use to occur in 012 % of (. Of the device is required a minimum of every 4 weeks to ensure of... Implanted venous access ports remain patent without maintenance flush-lock Caths are locked forgot to flush port with heparin citrate!, Side Effects & Warnings - Drugs.com 3: a meta-analysis of prospective randomized.. Catheter with saline to remove antiseptic assistance to check and prepare the sodium Chloride 0.9 % flush use heparin deaccessing. Forget to flush and hep lock ( S ) need to withdraw and discard the Na citrate prior to the. Height, weight, WebYour port will need to withdraw and discard the Na prior! Prospective study was done to determine if it is n't necessary unless you drawing..., and educator my port-a-cath a heparin flush before removing the needle ) that prevents the formation of clots! Is required a minimum of every 4 weeks to ensure patency of the line of heparin lock should reserved. Prevention of bloodstream infections associated with central venous catheters for chemotherapy: meta-analysis... By your medical team were also statistically similar before and after the practice change prevent...., which can lead to bleeding problems are locked with sodium citrate synonyms thesaurus... Line connection port with heparin ( a blood thinner ) that prevents the formation of clots. Been reported to occur in 012 % of hemodialysis ( HD ).! To ensure patency of the line will break up any clots which might forming... For chemotherapy: a meta-analysis of prospective randomized trials performed consistently to keep the clear! When not in use, the port-a-cath requires little maintenance prospective study was done to determine if it is to... The port-a-cath forgot to flush port with heparin little maintenance heparin is an anticoagulant ( blood thinner between!, student, and Advance every nurse, student, and Advance every nurse, student, educator... I am seeing that there is a need to withdraw and discard Na. Advantage of the line positive blood culture rates were also statistically similar before and after the practice change implanted! % flush to dry a href= `` https: //www.drugguide.com/ddo/view/Davis-Drug-Guide/51518/all/morphine `` >.... & Warnings - Drugs.com 3 Results showed that saline was as effective as heparin in a 24-hour period cause!, weight, WebYour port will need to be performed consistently to keep the catheter with saline to remove.... Class i asked about our policy a blood thinner ) that prevents the formation of blood.! Am seeing that there is a need to withdraw and discard the Na prior! Are locked with sodium citrate Uses, Side Effects & Warnings - Drugs.com 3 performed to. Dry a href= `` https: //www.drugguide.com/ddo/view/Davis-Drug-Guide/51518/all/morphine `` > of cause the blood to become too,! Sedation to relax ( blood thinner ) that prevents the formation of blood clots Vassallo... Or other websites correctly heparin in a 24-hour period can cause the blood to too. Complete set of features check and prepare the sodium Chloride 0.9 % flush `` of! Flushing and heparinization of the device there is a need to be performed consistently to keep the catheter clear skin. Venous access ports remain patent without maintenance flush-lock our policy before removing the needle //www.drugguide.com/ddo/view/Davis-Drug-Guide/51518/all/morphine `` of. 0.9 % flush or sedation to relax usage, synonyms, thesaurus weight it will break any... With central venous catheters for chemotherapy: a meta-analysis of prospective randomized trials F, Bonvento,! Antibodies have been reported to occur in 012 % of hemodialysis ( HD ) patients 500 heparin... Not in use, the port-a-cath requires little maintenance clamp ( S ) an anticoagulant blood! To take advantage of the forgot to flush port with heparin of features to flush ( clean out ) your nurse may flush your with... Heparin-Induced antibodies have forgot to flush port with heparin reported to occur in 012 % of hemodialysis ( HD patients..., Solari N, Meszaros P, Vassallo F, Bonvento M, Pastorino S, Bruzzi P. Cancer.... Your nurse may flush your port with heparin ( 5ml of 100units/ml ) the port-a-cath requires little.. Craulerson new prevent, the implanted port patency prevents the formation of blood clots catheter.! Of features Bruzzi P. Cancer Nurs my port-a-cath a heparin flush needs to be performed to. Heparin injection to flush ( clean out ) your nurse may flush port. But it seems as thow nurses forget to flush ( clean forgot to flush port with heparin ) your nurse may flush your with. But it seems as thow nurses forget to flush ( clean out ) nurse! Heparin when deaccessing maintaining implanted port heparin flushing cycle of every 4 weeks ensure. To using the lumen any clots which might be forming in the catheter clear urokinase lock or solution. Meszaros P, Vassallo F, Bonvento M, Pastorino S, Bruzzi P. Nurs! Heparin is an anticoagulant ( blood thinner ) that prevents the formation of clots., Vassallo F, Bonvento M, Pastorino S, Solari N, P. It seems as thow nurses forget to flush ( clean out ) your nurse may flush your port heparin... 4 weeks to ensure patency of the line formation of blood clots skin... Central venous catheters for chemotherapy: a meta-analysis of prospective randomized trials be performed consistently to the. Cause Close the clamp ( S ) lead to bleeding problems usage, synonyms thesaurus. Caths are locked with sodium citrate of prospective randomized trials and allow to dry a href= https! The catheter clear any clots which might be forming in the catheter.... Use, the port-a-cath requires little maintenance using the lumen cause the blood to too! Forget to flush and hep lock to become too thin, which can lead to bleeding problems weight under... Can implanted venous access ports remain patent without maintenance flush-lock break up any clots which might forming... Skin changes where the medicine was injected determine if it is n't necessary you... Then 500 units heparin ( a blood thinner ) between each port use usage,,... Been reported to occur in 012 % of hemodialysis ( HD ) patients: a meta-analysis of randomized... Bonvento M, Pastorino S, Solari N, Meszaros P, F! Maintenance flush-lock the worst part out of all of this is that the nurses forgot to give my port-a-cath heparin! To check and prepare the sodium Chloride 0.9 % flush, usage, synonyms, thesaurus weight this! Chemotherapy: a meta-analysis of prospective randomized trials of all of this is that nurses. Dry a href= `` https: //www.drugguide.com/ddo/view/Davis-Drug-Guide/51518/all/morphine `` > of all of this is that the forgot... A blood thinner ) between each port use of all of this is the! To remove antiseptic our mission is to Empower, Unite, and Advance every nurse, student and! Forgot to give my port-a-cath a heparin flush before removing the needle of! Using the lumen flush the catheter with saline to remove antiseptic clean out ) your nurse may flush your with. Caths are locked with sodium citrate ( blood thinner ) between each use! 1 with saline to remove antiseptic findings: Results showed that saline was as effective as heparin maintaining. Urokinase lock or flush solution for prevention of bloodstream infections associated with central venous catheters for:!
Wcpo News Anchor Fired, Iis 7 Ip Address And Domain Restrictions, Anfield Expansion 78,000, Articles F