The half life of tPA is very short - less than 5 mins - so there
should be no clinical problem. Your problem will be financial. Why
continue to use a product that is increasing your cost of providing
care? tPA and the nursing time to do the procedure is not cheap! I
would investigate the flushing techniques being used - no positive
pressure flushing technique with a positive displacement device. Also
what syringe are you using? There is blood reflux from 2 sources - the
syringe and the process of disconnecting from the catheter hub. The
positive displacement from the positive cap is probably not enough to
overcome the reflux from both of these. If you are not using a syringe
that has been redesigned to prevent this problem, I would suggest that
you teach them to not inject all the fluid from the syringe because it
is compression of the plunger rod tip that causes the reflex.
Lynn
At 8:23 PM -0400 4/23/06, Lorraine Campbell wrote:
Is there a limit to how many times Tpa may be used to open a blocked PICC line (or any other CVC for that matter)?
Since switching to Saline only flushes in our acute care facility a short while ago, we have seen a great increase in blocked lines --we do use a positive pressure cap but the staff does not always use it correctly. We are continuing to emphasize correct flushing protocol BUT in the meantime, is it contraindicated to use Tpa to open a blocked line more than once in a short time( within 24 to 48 hours)?
Lori Campbell CRNI
Avoca, PA
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
