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Pam Michael
De-clotting central lines

What are other facilities doing for de-clotting central lines? Not just PICC lines, but subclavian/IJ triple lumens.  Are you using activase? Do you have a standing order in place? 

Thanks.

 

mary ann ferrannini
Yes we use Tpa on all CVCs
Yes we use Tpa on all CVCs with PWOs and CVCs that are occluded  (non-precipitate). I wrote a protocol and procedure and we call MD and ask for what we want. Other agents( ie streptokinase) have a much higher incidence of allergic reaction. Although it can sometimes take longer than some of the older agents used ,but no longer available, ie. urokinase) it efficacy is greater. Genetech usually sends me  information yearly on the Activase (Cath-flo).  
hcnmccle
We obtain the order for
We obtain the order for Activase on admission.  Also, an important consideration is partial occlusion - as determined by the inability to aspirate blood, but still able to flush - we use activase in this scenario as well.
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