RE: Are you doing an instillation or an infusion of tpa? An infusion seems to work best for us for PWO.

[Blais, Gail]

We do this off and on for fibrin sheaths on ports, sometimes PICCs too. I can't remember the dose but it's pretty small, in 50ml of saline (both lumens if dual) over 3 hrs. This is done in the renal unit quite often of hemo-lines that fibrin sheath and don't give adequate blood back . So, intralumen if the problem is there and infusion if fluro has shown a fibrin sheath.  Gail -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Ward Gina Sent: Monday, March 20, 2006 4:05 PM To: Monica Sorg; [EMAIL PROTECTED] Subject: RE: Are you doing an instillation or an infusion of tpa? An infusion seems to work best for us for PWO. I would like to hear more about the infusion of Activase.  ( is that what you are using?)  Is that use approved?  What would make you select that instead of instillation and sit?   Thanks in advance, Gina Ward From: [EMAIL PROTECTED] on behalf of Monica Sorg Sent: Mon 3/20/2006 1:01 PM To: [EMAIL PROTECTED] Subject: Are you doing an instillation or an infusion of tpa? An infusion seems to work best for us for PWO. Are you doing an instillation or an infusion of tpa?  An infusion seems to work best for us for PWO...2 mg in 50 ml saline infused over 3 hours.  Also, are you using a positive pressure cap?  That should help as well.  Is it being flushed often enough with enough saline.  We use 20 ml saline using the push pause method q 8 hrs.  Just a few ideas to consider.       Monica Sorg, RN CRNI Infusion Nurse Specialist University of Louisville Hospital Louisville, KY   >>> "Ann Williams" <[EMAIL PROTECTED]> 3/20/2006 11:35 AM >>> Hi folks! We have a pt that has been requiring frequent declotting for PWO.  She was declotted successfully 2/20, 3/13 and now requiring it again.  She is being treated for an abscess in the spinal area and septicemia and has been on Vanco q12h since 2/10, and this past Friday (3/18) got switched to Merrem q8 and Zyvox q12.  She is 43yo and a compliant patient.  (YES there are some out there!!)  When we have PWO on one lumen, we Activase both lumens.  We flush with 10ml NaCl before and after each dose. Does anyone have any suggestions for a pt requiring such frequent Activase?  Is there something we are overlooking? Thanks! ann Ann Williams ----------------------------------------------------- Confidentiality Disclaimer This message, including any attachments, is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law, including PHI (Protected Health Information) covered under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.  If you receive this message in error, or are not the named recipient(s), please notify the sender or contact the University of Louisville Health Care I.S. helpdesk at 502.562.3637 to report an inadvertently received message.