The first question that comes to my mind is what dose/concentrations
of sodium citrate are commercially available now. I would do some
research on this with your pharmacist first. Several years ago, there
was a serious problem because there were 2 vastly different
concentrations of sodium citrate available. The larger dose was given
by accident and I think there was a serious problem. Someone else may
remember more details than I, but I do think it was in a dialysis
catheter flush issue. Lynn
At 10:46 PM -0500 6/21/06, [EMAIL PROTECTED] wrote:
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
--
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
