CATHFLO® (alteplase)

MIXING

1. Obtain a clear/clean space to prepare the Cathflo.

2. Be sure all the necessary supplies are available to complete the procedure from beginning to end. You will need sterile water, 10 ml syringe and a stopcock if line is fully occluded.

3. Use 2.2 ml Sterile water for Injection to reconstitute Cathflo.

4. Inspect the solution for any foreign matter or discoloration before use.

ADMINISTRATION:

1. Take baseline vitals and document basic assessment.

   
   

   PARTIAL OCCLUSION

2. Use a 10 ml syringe to instill the appropriate dose of Cathflo into the catheter.

3. Step 1: Wait for 30 minutes, then attempt to aspirate blood to check if the catheter is functional.

   • If functional proceed to Step 3

   • If NOT functional continue to Step 2

   Step 2: If the catheter remains occluded, wait an additional 90 minutes (for a total dwell time of 120 minutes), then attempt to aspirate blood again.

   • If Functional proceed to Step 3

   • If still occluded: A second dose of equal amount may be instilled.  Repeat reconstitution and administration steps.

   Step 3: If catheter function is restored:

   • Aspirate 4-5 ml of blood for patients ≥10 kg

   • Aspirate 3ml of blood for patients < 10 kg

   Step 4: Discard the aspirate to remove Cathflo and any residual clot

   
   

   COMPLETE OCCLUSION

4. Remove end cap (Microclave) and attach the luer end of the stopcock to the catheter, making sure the stopcock is in the OFF position.

   1. Add an empty syringe to one of the ports on the stopcock.

   2. Attach the syringe containing cathflo to the remaining port. Then turn the stopcock to the OFF position to the syringe containing cathflo.

   3. Gently aspirate the catheter using the empty syringe until the plunger is pulled back to the 8 – 9 ml mark.

   4. Turn the stopcock off to the empty syringe. This will allow the cathflo to be drawn into the central line. Repeat the negative pressure technique until the entire dose is drawn into the catheter. Depending on the size of the occlusion this may take some time. Be patient in instilling.

   5. As cathflo interfaces with the clot it will dissolve at the point of connection. Each time you repeat negative pressure it will agitate the fluid allowing for new clot surface to contact cathflo.

   6. Never repeat aspiration on the empty syringe as it will aspirate cathflo out of the catheter.

   7. Once the entire dose of cathflo has been instilled turn the stopcock off to the patient.

   8. Cathflo should now be allowed to dwell in the lumen

   9. Follow steps from above starting at step #3.

      
      

5. Flush with 10 ml 0.9% normal saline

6. Clean and dispose of used supplies.

7. Report results to Agency

ADDITIONAL INFO:

Medication Guide:  Cathflo® Activase®

Administration:  Administration

HHC Policy:  Cathflo policy