Milrinone drip how to declot noncontinuous ports

[Mmonroe1]

Question: patient has a triple lumpen pic with continuous milrinone drip. The line running milrinone is patent but other lumens are sluggish/occluded. Can you leave milrinone drip running while declotting other lumens with cathflo?

[Julius Seizure]

Some thoughts...

1) Milrinone is generally compatible with just about anything, as far as I can recall.

2) Milrinone also has a pretty long half life. If your line declotted quickly and easily, it probably wouldn't be devastating to pause the infusion if you wanted to take that extra precaution.

3) We use cathflo in babies to declot lines. You don't just push in as much as you want, you are supposed to use the amount that equals the fill volume of the catheter....it "dwells" and then you pull it back out. Little, if any, drug should enter systemic flow.

4) If we stopped all infusions to declot one single lumen, the babies would die.

5) IV-Therapy.net does not look like a super legit source.

[blondy2061h, MSN, RN]

Years ago a nurse on the IV team showed me a trick about how to unclog an occluded port without cathflo. I've used it for years and it works like a charm.

Well by all means, keep it to yourself

[mrsboots87]

Alteplase is given at 0.9mg/kg in stroke patients with a max amount given to 90mg. A 2 mg "dose" used to declot a line would only cause catastrophic bleeding to a very certain population of very sick people and small children. And even then, the risk of severe bleeding is small. I would not stop a cardiac drip to declot a line since the alteplase has to dwell at least 30 minutes. I've had to leave it in over an hour before for a stubborn line. The minuscule amount of that 2mg that may flow into the patient is extremely unlikely to cause harm to them.

Hell, when injecting, it's actually 2mg per 2.2 ml. So they probably aren't even getting the whole wopping 2 mg. I am not judging those who have been told so many times to something a certain way so they just do it. But I tend to always ask myself why. Someone can tell me 6 ways from Sunday that "we always do it like this" but if I am not given a sound and safe reason as to why, I look it up myself and find that they are either correct and why, or misguided and why and move on from there.

[Sunset17]

error

[Sunset17]

Years ago a nurse on the IV team showed me a trick about how to unclog an occluded port without cathflo. I've used it for years and it works like a charm.

well-what is it?