I have a question. (disclaimer-I am a trainer for Genentec) We currently allow patients to instill alteplase in their partially occluded lines who have been taught appropriately. we have a teaching sheet and these are patients who are self administering their therapy so have a basic knowledge of catheter care. I do not feel comfortable ever teaching a patient to instill cathflo in a totally occluded line because of catheter rupture and throwing the thrumbus. There are several nurses and radiologists who assure me that a clot on a central line would not cause a massive PE, that it would go to the lung beds which are very "forgiving". does anyone know of any articles specific to central line occlusions and complicatons associated if the clot is dislodged? any help would be appreciate. Katie
Literature is showing an increased risk of catheter-associated vein thrombosis producing PE. Lumen occlusions may be a different outcome but I seriously question the statement about how "forgiving" the lungs are. We are now seeing lots of information about how very small air bubbles can lead to pulmonary hypertension. Not a catastrophic event, but happens over time, but no less life-altering. I would start your lit search with the articles listed in the new INS standards, now standard on thrombosis and updated on on catheter clearance. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
thank you Lynn--