The dose of Open Cath is 2 mg per lumen for pts above 30kg. Pts weighing less than 30 kg should receive 110% of the intraluminal filling volume of the catheter.
The dose for AMI is 1.25 mg/kg to a dose max of 100mg.
The AIS dose is .9mg/kg to a max dose of 90mg
The adult dose for PE is 100mg.
Giving less than the 2mg dose to an adult with a partially occluded catheter is not recommended. It will sometimes work, as a certain percentage of thrombotic catheter occlusions and partial occlusions are intaluminal, but it will not address those occlusions that are extraluminal (fibrin sheath, for example) as the filling volumes are often greater than 1 ml and the drug can't get to the problem to work it's magic...
I would not try to "convince" an MD of anything. Sometimes that's like trying to teach a bear to sing--it wears you out and only irritates the bear. If they are
seeking advice and/or guidance in your area of expertise you can point out the dosing needed to clear the cath, give the percentages and let them decide. Given the information already discussed in this thread, a 2 mg dose of open cath seems a less dicey procedure than replacing a catheter in a pt at risk for bleeding does it not?
We may also be splitting hairs about the terms contraindications and precautions. I understand a contraindication to mean "just don't do it".
A precaution is where the risk vs benefit gets weighed and a decision made-hopefully by the MD with IV specialist input, as in the above example.
Kathy is correct in siting COOL1 and COOL 2, and for the pedi population check out the CAPS study.
So--there are studies that it is safe AND the combined success rate is 85-90%!
What a great product, n'est ce pas?
Betsy
p.s. if any of you are at facilities in Northern
California and would like an inservice on catheter clearance for your staff please contact me at my email address.
[EMAIL PROTECTED] wrote:
[EMAIL PROTECTED] wrote:
If we could continue the conversation of TPA I have two questions--(1) Since I am unfamilar with the dose given for Acute MI--if the dose of TPA administered for catheter occlusion is 1/50th the dose given for AMI how many times is that 1mg dose in relationship to the dose for AMI(2) If there are no TPA "contraindications" how does one convince an MD that it is safe to give that 1mg dose for a patient with DICThank you in advance for your insights--
Robbin K. George RN
Vascular Access Resource
Alexandria Hospital Virginia
[EMAIL PROTECTED]
