COOK Medical Turbo-Flo Gebrauchsanweisung Seite 5

• Catheter tip position should be verified by X-ray and monitored on a
routine basis. Periodic lateral view X-ray is suggested to assess tip location
in relation to vessel wall. Tip position should appear to be parallel to vessel
wall. (Reference 1)
PRECAUTIONS
• The product is intended for use by healthcare practitioners trained and
experienced in proper positioning of catheters in the central venous
system using percutaneous entry (Seldinger) technique. Standard
technique for placement of vascular access sheaths, angiographic
catheters and wire guides should be employed.
• Select puncture site and length of catheter needed by assessing patient
anatomy and condition.
• If lumen flow is impeded, do not force injection or withdrawal of fluids.
Notify attending physician immediately.
• Patient movement can cause catheter tip displacement. Catheters placed
via an antecubital vein have shown tip movement of up to 10 cm with
motion of the extremity.
• Catheter size should be as small as the use will allow.
• When exchanging a Twin Turbo-Flo Double-Lumen Catheter, ensure that
the wire guide is inserted into the hub marked "LARGE. "
PRODUCT RECOMMENDATIONS
Catheter Size and Puncture Site
Preliminary reports indicate that catheter size can influence clotting. Larger
diameter catheters have more tendency to promote clots. As reported by
Amplatz, Gianturco and others, clot formation has less relation to type of
catheter material than to size of catheter.
The angle of the catheter tip to the vessel wall should be checked carefully.
Blackshear reviewed the medical literature of catheter perforations, which
have confirming X-rays, and found that an incident angle of the catheter to
vessel wall greater than 40 degrees was more likely to perforate. (Reference 2)
The following variables must also be considered in selecting appropriate
catheter and length:
1. Patient history
2. Patient age and size
3. Access site available
4. Unusual anatomical variables
5. Proposed use and duration of treatment plan
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