AngioDynamics C3 WAVE SYSTEM Gebrauchsanweisung Seite 8

Confirm all Bundle Protocol Parameters have been met.
Catheter Insertion
Catheter advanced to target without
resistance?
Stylet removed from catheter without
resistance?
Catheter Functionality
Positive/free flowing blood return (all
lumens)?
Flushing without resistance (all lumens)?
Objective Assessment
US assessment of internal jugular vein
negative for catheter?
EKG tip location agrees with surface
measurement (+/- 2cm)?
ECG P Wave Assessment
Initial P wave downward deflection noted
and documented?
P wave amplification noted & highest
waveform documented?
Warning: If "no" is selected for "were all parameters met", you
cannot rely solely on the ECG interpretation by C3 Wave system.
You must obtain additional confirmation with chest x-ray or
fluoroscopy to confirm the PICC tip location.
Warning: Failure to verify catheter placement may result in serious
trauma or fatal complications.
A. As the catheter is advanced toward the SVC/Right atrial
junction the P-wave height will increase.
B. Advance Catheter until downward deflection is seen on the
leading edge of the P-wave. Select the "snapshot icon" using the
Remote Control to save the ECG waveforms.
Note: P-wave may continue to increase in amplitude when initial
downward deflection is observed. In this case, adjust catheter tip
position to maximum P-wave amplitude with no downward deflection
as shown below.
C. Pull catheter back until maximum P-wave is achieved.
D. Select the "snapshot" icon using the Remote Control Cable to
save the ECG waveforms. Refer to the C3 Wave Owners Manual.
E. Using the C3 Wave system, central venous catheter tip location
can be documented for the patient's chart. Refer to C3 Wave
Owner's Manual.
8. Complete PICC Placement Procedure.
A. Follow catheter Instructions for Use and institutional protocol.
• remove the stylet
• aspirate and flush catheter
• secure catheter
B. Remove drapes and ECG adhesive electrodes and discard
according to institutional protocol.
Caution: ECG Adhesive Electrode may damage the skin if
removed carelessly.
C. Disconnect Patient ECG Hub from ECG Clip Cable.
D. Dispose of the single use ECG Clip Cable, Remote Cover
according to institutional protocol.
E. Retain the reusable ECG Snap Leads, ECG Patient Hub; Remote
Control and clean per institutional protocol.
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