Cathflo standing orders

[MoopleRN]

Does anybody out there have standing orders per protocol for Cathflo to declot a line? Do you find other shifts aren't calling to get an order for it and then it falls on you? I'm getting very frustrated that other shifts aren't making an attempt to declot lines because they don't want to call for the order/actually administer it.

[MoopleRN]

I'm a doofus. Platelets are part of a CBC and most of our patients get that done frequently so it's not accurate for me to say they don't get checked often! They're usually WNL, however, so they often fly under my radar when I check labs.

[iluvivt, BSN, RN]

max dwell time is 2 hours for cath-flo...so if after 2 hours with no blood return or still occluded another dose is needed........if that does not work it is another problem usually a precipitate The manufacturer of the product recommends checking every half hour but it is not a big deal if you are busy and leave it in for 2 hours..especaiily if you do not need it right away.

[blondy2061h, MSN, RN]

Try and draw back q 30 min until blood return? Interesting. Our protocol is check for blood return after 30 min and if there isn't a return, check again after 90 min. If there's still no blood return, we have to call for another order and start all over again. How long do you keep checking for blood return before you give up?

Usually I'll leave it in til I need the lumen. If after 2 hrs or so I don't have blood return, I usually suspect it to be more of a positional thing than a clot thing. In fact, if I can push the cathflo in the lumen, just am not getting blood return, it's almost always a positional issue. I can't recall a single time I've ever had to TPA a valid lumen more than once to get it to work.

[blondy2061h, MSN, RN]

I've never heard of platelet parameters for cathflo. We use it routinely for patients with very low platelet counts. It's considered a topical drug, essentially, since it's not suppose to make it out of the CVL, and once blood returns we draw it back out. It's a very, very, very low dose- not nearly enough to act systemically in any meaningful effect.