Cathflo standing orders

Nurses General Nursing

Published

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.

:madface:

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Specializes in Cardiac Telemetry, ED.

We don't administer it. We call IV Therapy and make sure it's there for them when they come. And yes, I have had this passed on to me by the previous shift.

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We don't administer it. We call IV Therapy and make sure it's there for them when they come. And yes, I have had this passed on to me by the previous shift.

I don't understand why you have to call the IV team to give it...? Per my facility, we have to check for blood return before giving IV meds and if we don't have one, the line isn't considered patent, even if it flushes ok. No blood return = call for Cathflo. What does your IV therapy team do differently that they need to be called?

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Specializes in Cardiac Telemetry, ED.

They probably don't do anything differently. That's just a task that is specifically under their umbrella. I really don't mind, as I have plenty to keep me busy.

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Specializes in Oncology.

We have orders for it, and everyone is very good about using it. I'm rarely left with non-functioning lumens, and rarely leave others with them. We use 2mg in 2ml with orders to insert it and try and draw back q30min until blood return.

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I would like to be under that umbrella when I've got piggybacks due and the lines are clotted!! My biggest problem isn't taking the time to give it/wait for it to work, it's having to do it because the previous shift (shifts?) didn't get it done! If we had standing orders, perhaps the other shifts would be more willing to administer it because they wouldn't have to call and get the order.

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Specializes in Cardiac Telemetry, ED.

I'm surprised you don't have standing orders for it too. Is this something you can take up with your manager?

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We have orders for it, and everyone is very good about using it. I'm rarely left with non-functioning lumens, and rarely leave others with them. We use 2mg in 2ml with orders to insert it and try and draw back q30min until blood return.

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?

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I'm surprised you don't have standing orders for it too. Is this something you can take up with your manager?

We're trying but they're not exactly in any rush to change policy. There is a concern that patients with low platelets wouldn't fit in with a standing order and I can understand that. OTOH, the attending could write a specific order offsetting the protocol eg call if no blood return from CVL, do not give Cathflo per protocol.

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Specializes in Cardiac Telemetry, ED.

Or the protocol could include platelet parameters.

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It could... but most patients don't get their platelets checked very often. Having platelet parameters sounds like a really good idea on the oncology unit, though! Thanks for the input!

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Specializes in Cardiac Telemetry, ED.

Ah, I see. Our patients often get daily or QOD hemograms since many of them are on anticoagulation therapy.

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