I am writing in response to the article, “Reteplase: Nursing Implications for Catheter-Directed Thrombolytic Therapy for Peripheral Vascular Occlusions” (June 2002:57–63). The article was informative and comprehensive in regards to dealing with occlusions, but I found a couple of procedures that differ from those we use in our institution. At our institution, we treat patients in the progressive care unit with infusions of reteplase. We have found that the nurses can handle the hourly checks with another patient and, therefore, we save the cost of an intensive care unit bed. Also, we give all of our patients a continuous dose of patient-controlled analgesia of either Dilaudid or morphine. This practice has greatly improved the comfort of the patients and gives them some control in a very stressful time.

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