Declotting Picc Line With Heparin
If catheter function is not restored at 120 minutes after 1 dose of cathflo a second dose may be instilled see instructions for administration.
Declotting picc line with heparin. The patient is taken to the treatment room for whatever time is required for the procedure and charged accordingly. This is done by a nurse using activase injected directly into the line. Her technique was to declot with heplock and a tb syringe. There have been multiple reasons given for this including heparin allergy interference with clotting etc.
Anyway we use groshong piccs. A clotted picc line can be relieved by injecting cathoflo activase or alteplase recombinant 1 mg hcpcs code j2997 directly into the line. Make sure to perform this using whatever policy is in place at your hospital. Obtain an order to declot the catheter or to remove it.
In order to avoid large total doses and systemic effects use 0 5 unit ml in low birth weight premature newborns and in other patients receiving multiple lines containing heparin. Request an x ray be taken to verify catheter tip placement when a recent within 24 hours image is not available. Activase 1mg iv to declot picc. The only time heparin is used is for unused lumens of hickmans deaccessing pacs etc.
Notify the physician the catheter is not functioning properly. On january 13 2015 january 1 2019 by kandas 3 comments on how to flush a picc line with saline and heparin battling bertha if you have a picc line it needs daily flushing with saline and heparin to keep the line clean and prevent blood clotting. Example of a declot catheter order. This substance dissolves fibrin a substance that causes blood to clot breaking down the thrombus and restoring function.
Heparinize with a usual final concentration of 1 unit ml. The picc nurse said it was quite appropriate for a floor nurse to first try and declot troubleshoot before calling in the picc team worst case scenarios i guess they redivase. One common way to declot a picc line is by using alteplase rtpa to break up the clot. I needed to use tpa on a picc line recently and this is not only our hospital policy but it seems to be the common way to instill tpa into a picc line.
Ib flush each lumen with sterile 0 9 preservative free sodium chloride solution normal saline ns and attempt to aspirate blood from each lumen to determine ease of flush and aspiration. There is no efficacy or safety information on dosing in excess of 2 mg per dose for this indication.