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GOOD SHEPHERD MEDICAL CENTER
POLICY
Division: Clinical
Effective Date:
March 15, 2009
Page 1
Department: Nursing
Date/Historical File:
March 12, 2008
June 12, 2007
August 7, 2003
October 1998
VP/Committee Approval:
Nursing P&P 11/08
Patient Care 03/09
Exec. 04/09
Subject: Declotting of a Central Catheter Using Cathflo Activase 2mg
Purpose: To establish a protocol to restore the patency of an occluded central venous catheter
with Cathflo Activase and in accordance with the Mosby procedure (Declotting of a Central Line).
Policy:
 Cathflo is to be administered by an RN that has completed initial competency and
updates as needed.
 Central Venous catheters appropriate for Cathflo Activase:
o CVC’s (tunneled and non tunneled)
o Implanted venous ports
o Peripherally inserted central catheters (PICC)
 Cathflo Activase is indicated for the restoration of function to central venous catheters
obstructed by clotted blood or a fibrin sheath. The obstruction may be partial or
complete. Central venous catheter occlusion is defined by:
o Difficulty flushing
o Inability to draw at least 3mL of blood
o Failure to infuse (complete occlusion)
 Notify the physician if a central venous catheter becomes occluded. Obtain an order for
Cathflo Activase 2mg per port (times the number of ports occluded). May be repeated
one time per port if necessary.
Contraindications:
 Catheter patency may be impaired by circumstances other than a fibrin clot, such as
catheter malposition, mechanical failure, lipid deposits, or drug precipitates.
o Cathflo Activase is not effective in such cases
 Cathflo should not be administered to patients with a known hypersensitivity to Activase
or any component of the formulation.
 Do not administer Cathflo if patient has any signs of infection such as redness, exudate,
or warmth around catheter site. If you suspect an infection, notify the physician.
Reference: Mosby’s Skills – Central Venous Access Devices: Declotting with Alteplase
(Cathflo Activase), Extended Text
Reviewed By: D. Tevebaugh, RN, PICC
Reviewed by: K. Howard, MD, Radiologist
Revised By: Denise Fussell, RN, PICC
Denise Fussell, RN PICC
Revised by: Heather Biddy, RN PICC
05/07
03/08
02/08
11/08
3/14