Using a Thrombolytic in a Completely Blocked Catheter. Diagram 1. (a) Attach 3-way-tap & syringes Three-way Tap Technique see right. (available from DCCQ/CCU) (b) Open clamp (if there is one). (c) Open stopcock to the syringe and the blocked catheter. (d) Pull back on the plunger of the empty syringe to create a vacuum in the catheter. You will need to pull forcibly. (e) Maintain suction with one hand and with the hand turn stopcock so it is closed to the empty syringe and open to the syringe containing thrombolytic, which will be sucked into the catheter. Don’t worry if it seems that very little thrombolytic is sucked in: even a tiny volume will several cm into the catheter. DO NOT (f) for 1-2 hours. CATHETER as this will prevent the thrombolytic from penetrating into the line. (g) this time, attempt withdrawal of blood. If this is not possible, attempt to flush the catheter using 0.9% Sodium chloride in a 10ml syringe. Do not use excessive force. (h) This procedure often needs to be repeated several times before it works: sometimes leaving the thrombolytic in overnight seems to help1. Don’t worry about overdosing the patient: if the catheter is blocked they won’t actually have received any of the drug. (i) If the procedure fails despite repeated attempts consult IV or medical team with a view to removing the catheter. Appendix 6: Glossary of Complications
Using a Thrombolytic in a Completely Blocked Catheter. (a) Attach 3-way-tap & syringes Diagram 1. see right. (available from DCCQ/CCU) Three-way Tap Technique (b) Open clamp (if there is one). (c) Open stopcock to the syringe and the blocked catheter. (d) Pull back on the plunger of the empty syringe to create a vacuum in the catheter. You will need to pull forcibly. (e) Maintain suction with one hand and with the hand turn stopcock so it is closed to the empty syringe and open to the syringe containing thrombolytic, which will be sucked into the catheter. Don’t worry if it seems that very little thrombolytic is sucked in: even a tiny volume will several cm into the catheter. (f) for 1-2 hours. DO NOT CATHETER as this will prevent the thrombolytic from penetrating into the line. (g) this time, attempt withdrawal of blood. If this is not possible, attempt to flush the catheter using 0.9% Sodium chloride in a 10ml syringe. Do not use excessive force. (h) This procedure often needs to be repeated several times before it works: sometimes leaving the thrombolytic in overnight seems to help1. Don’t worry about overdosing the patient: if the catheter is blocked they won’t actually have received any of the drug. (i) If the procedure fails despite repeated attempts consult IV or medical team with a view to removing the catheter. Appendix 6: Glossary of Complications
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