TPA Administration Guidelines

Updated 1/2019 TPA Administration Guidelines 1. Please make sure the patient nurse, charge nurse, and primary team are aware that you are going to be instilling TPA into the chest tube. 2. Order the TPA in EPIC (type “alteplase” into orders – select order for “alteplase for chest tube”) 3. When the TPA is at the bedside, do a medication check with the nurse at bedside – verifying that it is the correct patient and medication, crosschecking with the patient’s ID band. 4. Ensure that there is a blue IV cap on the stopcock to keep the system closed and sterile. 5. Scrub the blue stopcock with chlorhexidine. 6. Attach the TPA syringe, and instill into the chest. Remove syringe, leaving blue IV cap. 7. Turn stopcock so that it remains closed and leave the TPA in the chest for an hour. 8. An hour later, turn stopcock to allow chest tube to drain.