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Ann,
Just some food for
thought....
For the infusion you
would use 2 mg/50 mls of diluent to infuse over 2 - 4 hours.
You would put 2 mg/2 mls
in a clotted catheter. Most catheters hold 1 mls or less.
So we are injecting tPa
out the end of catheter every time we use Cathflo.
Half life of tPa is 6
minutes from the time it comes in contact with the fibrin.
Since you would be
infusing the 2 mg over 2 hours you would be infusing less
tPa over a period of time
than if you injected the extra 1 mg out the end of the
catheter.
The dose of 2 mg of
Cathflo is 1/50th of the dose use for MI.
I have not done home
health in many years but I would be very comfortable with
doing this in the
home. We do infuse in an outpatient setting at least once a
week.
Hope this
helps
Margy Galloway,
RN
We are doing the CathFlo in the
home.......I'm sorry I wasn't clear...I was wondering if anyone is doing the
infusion in the home...
Thanks!
Ann Williams RN CRNI
Infusion Specialist
Deaconess Home Services
600 Mary St.
Evansville, IN 47747
812-450-3828
812-450-4665 FAX
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
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
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