Alteplase...

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Specializes in Post Anesthesia.

The nurse shouldn't have been "snippy" with you but I bet you will always remember how to declot a line in the future. Whenever we ask a patient the nursie question "how do you learn best.. written, demonstration, verbal... I always think --"I learn best by someone screwing up and getting chastised about it- usually me". As far as harm to the patient- consider this-would they let nurses instill the "clot buster" in a line going into the patient if it had the potential to cause serious harm if it got all the way into the patient?- no. At my hospital this is a nursing order- no doc required. If the hospital allows a nurse to give something without a MD ordering it it's got to be pretty benign.

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Specializes in ICU/Critical Care.
The nurse shouldn't have been "snippy" with you but I bet you will always remember how to declot a line in the future. Whenever we ask a patient the nursie question "how do you learn best.. written, demonstration, verbal... I always think --"I learn best by someone screwing up and getting chastised about it- usually me". As far as harm to the patient- consider this-would they let nurses instill the "clot buster" in a line going into the patient if it had the potential to cause serious harm if it got all the way into the patient?- no. At my hospital this is a nursing order- no doc required. If the hospital allows a nurse to give something without a MD ordering it it's got to be pretty benign.

True that. I feel better not that I talked to you and a couple other people about it. I did my reseach on the Cathflow and as I said in another post. The 2mg of alteplase has a short half life and does not have much affect on the plasma levels even if a small amount enters the blood.

When I read the dosing chart for Alteplase, 9mg initial bolus would be needed for someone who is over 500lbs. I don't feel bad about it now and you're right, I'll probably remember this because I got snipped at for it.

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Specializes in Oncology.

Our policy is to inject it into the lumen, let it sit for 30 minutes, and pull it back. People get really upset here too if you don't pull it back as well.

It's funny, cause almost everyone on my floor has an order for it, and my patient who clotted off today didn't. Irritating.

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Specializes in ICU/Critical Care.

Yeah, both of my patients needed it too yesterday. How nice of the night nurse to leave it for me to do. Anyhow, came into work and patient is fine. Talked to a couple of other nurses who said it wasn't a big deal for this patient. Its only 2mg and she's a large lady. But I didn't sleep all night because I was worried about it.

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Specializes in Oncology.
Yeah, both of my patients needed it too yesterday. How nice of the night nurse to leave it for me to do. Anyhow, came into work and patient is fine. Talked to a couple of other nurses who said it wasn't a big deal for this patient. Its only 2mg and she's a large lady. But I didn't sleep all night because I was worried about it.

Awwww, I hate loosing sleep over worrying. It stinks. I felt bad leaving 2 clotted lines for the day shift nurse last night.

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Specializes in Infusion Nursing, Home Health Infusion.

Michagen, Do not forget to prepare the Tpa correctly mixing with 2,2ml sterile water,anything else and the drug may not work. Also remember to usr only a 10 ml syringe so as not to damage the PICC. The maximum dwell time is 2 hours. Also PWO (persistant withdrawl occlusions) should be treated with Tpa. PWOs are when you are able to instill but not withdraw blood on a persistant basis. Sorry the nurse snipped at you. I would say to her "I guess you were born a nurse". Do not take her crap anymore or she will continue to dish it out".

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