Hi Kelly,
Since what you want to treat will usually be a fibrin sheath that is outside
of the catheter, you will want the tPA to exit the catheter tip. The tPA
left in port/catheter will do no good. So if you are worried about bleeding
for a patient, this might be an issue. Although what you will administer is
about 2% of the MI dose, so it's not much. I do think problems could arise,
but I've never seen or heard of an example in our dept since 1989.
We routinely use tPA for thrombotic occlusions.

Mats in Stockholm


Den 06-09-28 22.13, skrev "Kelly Murphy" <[EMAIL PROTECTED]>:

> I don't know about our policies, but my question is in
> addition to yours - if TPA is used to declot a line
> properly, it should never enter the patient's
> bloodstream, right?  So, there shouldn't be any
> contraindications, right?  This isn't to argue, I
> honestly want to know.
> Thanks,
> Kelly
> 
> --- Moore Beverly <[EMAIL PROTECTED]> wrote:
> 
>> TPA has the following contraindications:
>> a.       Active internal bleeding
>> b.      History of recent CVA (2 months or less)
>> c.       Intracranial or or intraspinal bleeding
>> d.      AV malformations or aneurysm
>> e.       Recent (2 months or less) intracranial or
>> intraspinal surgery
>> f.        Uncontrolled hypertension
>>  Do you list any complications of Cathflo Activase
>> in your policies?  I
>> know the salesman says there are no
>> contraindications,  Most of the
>> doctors around here will not order if they are
>> worried about bleeding.
>> I don't have a package insert here at this time to
>> read.
>> 
> 
> 
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