cathflo error



i put this into a PICC to lyse a clot but forgot to put a sticker on it or mention it to the next shift. they flushed it... into the patient.

4mg total. patient weights 376 lbs.

what should i be looking out for when i return the next shift?


i did this towards the end of shift when i was trying to pull blood for labs, but realized it was clotting. it was ok when i started shift. i forgot to mention it, until was almost out the door. the oncoming shift already put a saline flush through it, though.

i called the MD and the pharmacist. MD told me not to worry about it. pharmacist wasn't any help. the oncoming nurse flipped a lid and told me now the patient is going to go into DIC. i never used this drug before. she has 10+ years... i have 3 years. i'm worried. that's all.

not sure why my original thread was moved into the student forum. please delete that one. thanks!


1,224 Posts

Specializes in Medical-Surgical/Float Pool/Stepdown. Has 6+ years experience.

Is cathflo not activase as in TPA that they give patients continuously through a sheath to break up a clot...?

If it is, look at the halflife, there's a reason it's only good for so long in a lumen when declotting. I'd be worried about incompatibilities...


1 Article; 2,674 Posts

Specializes in ICU, LTACH, Internal Medicine. Has 10 years experience.

Alteplase (which is Cathflo) dose for stroke, for example, is 0.9 mg/kg. 4 mg for >350 lbs is not enough for anything.

Alteplase does not cause DIC. It is an enzyme which only works on formed/formung cloths. The products of their degradation under enzyme action can cause DIC, but there should be a large cloth and therapeutic concentration of the drug to begin with.

There is close to 100% possibility that nothing will happen, so just relax.

Since these schmolicies are really difficult to remember, I keep a bunch of bright red bookmarks in my pocket. I put one on syringe and leave it attached to the port. This prompts the next shift to ask question of what the heck it might mean and at least not to flush it.