Reply To: TPA dosing

  • Louis Ruggiero

    May 1, 2020 at 4:38 pm

    ​Hi Ashley,

    We dose TPA according to patient weight (see below). We also give 2mg/2ml for ports but the patient needs to be >10kg. We are able to redose a second time if after 2 hours the initial dose doesn’t work.

    It makes sense to give a 0.33mg/0.33ml (length + 10%) or standard 0.5mg/0.5ml dose for a catheter length/reservoir of 0.3ml. – correction on dosing

    a. Patients <10 kg: 0.5 mg/0.5ml
    b. Patients 10-30 kg: 1 mg/1 ml
    c. Patients >30 kg: 2 mg/2ml
    d. Implanted ports in patients >10kg: 2mg/2ml

    Hope this helps,

    Louis Ruggiero, BSN, RN, CPHON
    Clinical Educator – Infusion Center
    Children’s Hospital Los Angeles
    Original Message:
    Sent: 05-01-2020 04:17 PM
    From: Ashley Varnes
    Subject: TPA dosing

    Can anyone share their policy on TPA administration? Specifically dosing for ports and broviacs/piccs?
    Previously we administered 2m/2ml for all ports. However, we have had quite a few mini ports placed recently and they have a 0.3ml reservoir. I have been working with pharmacy and we wanted to reach out to other institutions to see if you use a standard dose for ports or do you dose based on size of port?

    Thank you!

    Ashley Varnes, MSN, RN, CPHON, CPN, BMTCN
    Clinical Practice Nurse Expert
    Cancer and Blood Disorders Unit
    Pediatric Hematology/Oncology
    Medical University of South Carolina
    Shawn Jenkins Children’s Hospital