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    An internal external biliary drainage catheter goes through your skin and into your bile ducts across the blockage One end of the catheter will sit in your small intestine and the other will come out of your body and will be attached to a drainage bag see Figure 3 This catheter lets bile flow in 2 directions either out to the external

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    through three way stopcock over 30 seconds followed by a 10 ml NS flush Close stopcock to patient for one hour Then open the stopcock and place chest tube back to suction NOTE Pharmacy to send 1st DNase dose now Pharmacy to time second dose for 1100 or 2300 whichever is greater than 14 hours after first dose t PA ordered

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