EBB 104 – The Evidence on Saline Locks

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In this episode, I explore the latest evidence on the use of saline locks!

A saline lock – sometimes called a “hep-lock” in reference to how it used to be used – is an intravenous (IV) catheter that is threaded into a peripheral vein, flushed with saline, and then capped off for later use. Nurses use saline locks to have easy access to the vein for potential injections. They can be useful in administering drugs as needed, and in the event of emergency surgery.

What is the latest research on the use of saline locks in labor and delivery? What is the evidence for the saline lock in someone who wants an un-medicated birth or wants to avoid medical interventions as much as possible? Should a saline lock be in place “just in case” it may be needed? I’ll cover the evidence on this topic, along with the risks and benefits.

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RESOURCES:

Bailey, J. M., C. Bell, R. Zielenski (2019). “Timing and outcomes of an indication-only use of intravenous cannulation during spontaneous labor.” J Midwifery Womens Health 00:1-7. 

Bateman, B. T., M. F. Berman, et al. (2010). “The epidemiology of postpartum hemorrhage in a large, nationwide sample of deliveries.” Anesthesia and analgesia 110(5): 1368-1373.

Maki, D. G., D. M. Kluger, et al. (2006). “The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies.” Mayo Clin Proc 81(9): 1159-1171.

Newton, N., M. Newton, et al. (1988). “Psychologic, physical, nutritional, and technologic aspects of intravenous infusion during labor.” Birth 15(2): 67-72.

Rickard, C. M., D. McCann, et al. (2010). “Routine resite of peripheral intravenous devices every 3 days did not reduce complications compared with clinically indicated resite: a randomised controlled trial.” BMC Med 8: 53.

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