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Rebick
what to dilute t-PA with

Hi guys!  My new question is, if the catheter you're declotting requires more than 2mg (2ml) of alteplase as the catheter for example is longer or has a bigger diameter, would you further dilute the alteplase solution with sterile water or preservative-free 0.9NaCl to get the necessary volume?

Chris Cavanaugh
Question for your CathFlo Rep

I think that would be a question for your Cath Flo Rep.   I am not aware of any PICC lines that would require more than a 2 mL priming volumn for each lumen, nor am I aware of any non-tunneled central lines that have more than a 2 mL priming volumn in each lumen.  

Curious as to what type of catheter you are declotting?

 

Chris Cavanaugh, RN, BSN, CRNI, VA-BC

Chris Cavanaugh
Question for your CathFlo Rep

I think that would be a question for your Cath Flo Rep.   I am not aware of any PICC lines that would require more than a 2 mL priming volumn for each lumen, nor am I aware of any non-tunneled central lines that have more than a 2 mL priming volumn in each lumen.  

Curious as to what type of catheter you are declotting?

 

Chris Cavanaugh, RN, BSN, CRNI, VA-BC

lynncrni
I would agree with Chris.

I would agree with Chris. Several years ago, I assessed a chart of multiple implanted ports from a company that had many different types. The largest port body with the untrimmed catheter and the largest port access needle with longest extension set was about 2.5 mL internal volume. All others would be far less than this. Remember that a catheter trimmed to patient length would have a smaller internal volume than what the manufacturer provides in their IFU. 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

Kathleen M. Wilson
I would not add sterile water

I would not add sterile water because you are changing the concentration of the drug. You would mix up two vials up the drug, each with 2.2 cc sterile water, and then use all of one and part of another, depending on the volume you need.

Kathleen Wilson, CRNI

lynncrni
Kathleen's approach is

Kathleen's approach is exactly what I would do also. 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

Rebick
Thank you for your replies,

Thank you for your replies, Kathleen, Lynn and Chris.  There was no specific catheter to be declotted (yet).  We were reviewing our P & P and this question came up

Dianne Sim RN VA-BC
what to dilute t-PA with

Make sure it is non-bacteriostatic sterile water also, as the alcohol in the bacteriostatic sterile water damages the Activase molecule.

Dianne Sim RN, VA-BC

IV Assist, Inc

 

Dianne Sim RN, VA-BC, CEO; IV Assist, Inc.

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