Is your concern that it was "flushed" meaning it was given to quickly? or was it given in the wrong lumen?
We use cathflo very often. We treat only the affected lumens.
If Cathflo was administerd in a line, wether it was fast or slowly I would wait the 30 minutes -2 hours, not using the line at all, and then check intermittently for blood return. If after the 2 hours it is not effective than it can be repeated as directed.
Hope this helps, I dont want to go on and on about how we utlize it for fear I am not understanding your question.
Sorry for the confusion. The RN was unfamiliar with the administration of Cathflo. She was unable to get a blood return from the lumen where Cathflo was dwelling and flushed the lumen with 20cc of saline sending it systemically.
Cathflo/Alteplase is safe to instill immediately in a partially or occluded lumen and the half-life of this drug is less than 5 minutes if it goes systemically.
A very good example of why documented competency with this and all skills are required by Joint Commission and others. Yes, tPA has a short half life. Also an expensive mistake. So the recommendation above to wait for the 30 minutes to 2 hours, checking for blood return and giving another dose is a good one.
need clarification;
Is your concern that it was "flushed" meaning it was given to quickly? or was it given in the wrong lumen?
We use cathflo very often. We treat only the affected lumens.
If Cathflo was administerd in a line, wether it was fast or slowly I would wait the 30 minutes -2 hours, not using the line at all, and then check intermittently for blood return. If after the 2 hours it is not effective than it can be repeated as directed.
Hope this helps, I dont want to go on and on about how we utlize it for fear I am not understanding your question.
Gina
Gina Ward R.N., VA-BC
Sorry for the confusion. The RN was unfamiliar with the administration of Cathflo. She was unable to get a blood return from the lumen where Cathflo was dwelling and flushed the lumen with 20cc of saline sending it systemically.
Cathflo/Alteplase is safe to instill immediately in a partially or occluded lumen and the half-life of this drug is less than 5 minutes if it goes systemically.
Thank you for your response!
A very good example of why documented competency with this and all skills are required by Joint Commission and others. Yes, tPA has a short half life. Also an expensive mistake. So the recommendation above to wait for the 30 minutes to 2 hours, checking for blood return and giving another dose is a good one.
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 and I agree. This nurse was not compentncied for this procedure.