Used to be to treat clogged IJ's we just installed 2mgs tpa in amount listed on the side of each IJ lumen in sterile water. In and out in 5 minutes. Dialysis nurse would pull it off with next treatment. But our new doctor wants us to do a 4 hour tpa infusion in each lumen. to bath the catheter with tpa. We are using 50 cc bags of sterile water. I've not done it yet. It pulls a RN out of the loop for 4 hours. The dialysis pt has to hang around for 4 hours. Plus they are getting 4 mg's tpa systemically. I don't think we are checking coags before. Shouldn't we if they are on blood thinnners?
Is this how every one else does it?