Declotting Picc Line With Alteplase

One common way to declot a picc line is by using alteplase rtpa to break up the clot.

Declotting picc line with alteplase. Repeat x1 for 2 hours if not successful. Use of alteplase for declotting of catheters should trigger heightened awareness of infection risk. Attempt to aspirate for a blood return. Thrombi in around a central line facilitate adhesion of bacteria.

Attach a 10 ml syringe to the hub. Cathflo activase should be used with caution in the presence of known or suspected infection in the catheter. Make sure to perform this using whatever policy is in place at your hospital. This substance dissolves fibrin a substance that causes blood to clot breaking down the thrombus and restoring function.

Picc non tunneled tunneled implanted port includes volume of reservoir catheter and needle infusion set. Activase 1mg iv to declot picc. Alteplase is a tissue plasminogen activator t pa used as a clot buster for myocardial infarction and stroke. Notify the physician the catheter is not functioning properly.

Let sit for 30 minutes draw the clot back into the syringe. Obtain an order to declot the catheter or to remove it. This is done by a nurse using activase injected directly into the line. It can be very frustrating when you go to draw blood from a picc line and it is clotted off.

A clotted picc line can be relieved by injecting cathoflo activase or alteplase recombinant 1 mg hcpcs code j2997 directly into the line. Request an x ray be taken to verify catheter tip placement when a recent within 24 hours image is not available. Draw back on the empty syringe creating a vacuum in the picc line between the stop cock and the clot switch the stop cock to the cathflo and the tpa is sucked up to the clot. Lines suitable for declotting.

As with all catheterization procedures care should be used to maintain aseptic technique. Using aseptic technique clean the catheter hub with an approved antimicrobial solution. Example of a declot catheter order. 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.

If no blood returns connect the syringe with the alteplase and instill the alteplase into the catheter. Alteplase is an enzyme that converts plasminogen into plasmin which then degrades the fibrin existing in blood clots. The patient is taken to the treatment room for whatever time is required for the procedure and charged accordingly.