MedComp VASCU-PICC Gebrauchsanweisung Und Pflegetipps Seite 9

5.
Remove the syringe and place thumb over the end of the needle to
prevent blood loss or air embolism. Draw the flexible end of
marked .018" guidewire back into advancer so that only the end of
the guidewire is visible. Insert the advancer's distal end into the
needle hub. Advance guidewire with forward motion into and past
the needle hub into the target vein.
Caution: The length of the wire inserted is determined by the size of the
patient. Monitor patient for arrhythmia throughout this procedure. The
patient should be placed on a cardiac monitor during this procedure.
Cardiac arrhythmias may result if guidewire is allowed to pass into the
right atrium. The guidewire should be held securely during this
procedure.
6.
Remove needle, leaving guidewire in the target vein. Thread sheath/
dilator over the proximal end of the guidewire into target vein.
Remove the guidewire leaving the sheath and dilator in the vein.
Caution: DO NOT bend the sheath/dilator during insertion as bending
will cause the sheath to prematurely tear. Hold sheath/dilator close to
the tip (approximately 3cm from tip) when initially inserting through the
skin surface. To progress the sheath/dilator towards the vein, re-grasp
the sheath/dilator a few centimeters (approximately 5cm) above the
original grasp location and push down on the sheath/dilator. Repeat
procedure until sheath/dilator is fully inserted.
Caution: Never leave sheath in place as an indwelling catheter. Damage
to the vein will occur.
7.
Loosen locking collar of sideport and withdraw stylet back beyond
the point where the catheter is to be trimmed by at least ¼ inch
(1cm). Cut catheter to length determined by marked guidewire.
Caution: Never attempt to cut stylet.
Caution: Always withdraw stylet back beyond the tip of the catheter
prior to insertion.
8.
Once proper catheter length and stylet position has been achieved,
tighten locking collar to keep stylet in place.
9.
Remove dilator from sheath.
10.
Insert distal tip of catheter into and through the sheath until
catheter tip is correctly positioned in the target vein.
11.
Remove the tear-away sheath by slowly pulling it out of the vessel
while simultaneously splitting the sheath by grasping the tabs and
pulling them apart (a slight twisting motion may be helpful).
Caution: Do not pull apart the portion of the sheath that remains in the
vessel. To avoid vessel damage, pull back the sheath as far as possible
and tear the sheath only a few centimeters at a time.
12.
Make any adjustments to catheter under fluoroscopy. The distal tip
should be positioned at the level of the caval atrial junction.
Caution: Do not clamp the lumen portion of the catheter. Clamp only
the extension(s). Do not use the serrated forceps, use only the in-line
clamp(s) provided.
13.
Loosen locking collar of sideport. Remove the stylet by applying
gentle pressure with one hand above the insertion site while
grasping the stylet with the other hand and slowly pulling back
with a constant motion. Remove sideport adapter and replace with
needleless access port. Attach saline filled syringe to needleless
access port, aspirate lumen and then irrigate with saline. Remove
syringe prior to clamping extension.
Caution: If difficulty and/or bunching of the catheter lumen are
experienced while removing the stylet, additional flushing of the catheter
may be helpful. The catheter may need to be repositioned to allow for
removal of the stylet.
Caution: Do not attempt to reinsert stylet once it has been withdrawn.
Caution: Never leave stylet in place after catheter insertion; injury may
occur. Remove both stylet and sideport adapter after insertion.
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