My last question was about using sodium citrate, instead of heparin, for CVC. The catheter in use is a hemodialysis catheter.
The patient has TTP (thrombotic thrombocytenia purpura) and has a tunneled hemodialysis catheter. The patient had plasmapheresis and now getting chemo. The doctor doesn't want to use heparin and wants the nurses to use sodium citrate. I have found much information this practice, but thanks to the few that did respond. One of the responses included using CLC for the cap to avoid heparin. Anyone else have experience with this that you could lead me in the right direction for more information? Sorry to ask again, but thought if I clarified the type of catheter there might be more responses. I am being asked to create a policy and procedure for this. I am resistant to do that for 1 patient (I know there might be someone else at some time). Currently, I am recommending the doctor write the order for the substitution of sodium citrate dose/volume/etc., instead of creating a policy. Am I wrong? I need some feedback about thinking that writing a policy won't cure this problem. It is a medical order, not a policy. Right? Gwen
