MedComp Dignity Titanium Gebrauchsanleitung Seite 6

• If you choose to insert the catheter into the subclavian vein, it should be
inserted lateral to the border of the first rib or at the junction with the axillary
vein because such insertion will avoid compression of the catheter, which can
cause damage and even severance of the catheter. The use of image guidance
upon insertion is strongly recommended. A radiographic confirmation of
catheter insertion should be made to ensure that the catheter is not being
pinched.
IMPLANTATION PREPARATION
1. Select implantation procedure to be used. Note: Recommended veins for arm
placement are cephalic, basilic, or medial cubital basilic. Note: Recommended
veins for chest placement are internal jugular or lateral subclavian. Refer
to "Warning" section covering catheter pinch-off if inserting the catheter via
subclavian vein.
2. Select the site for port placement. Note: Port pocket site selection should
allow for port placement in an anatomic area that provides good port stability,
does not interfere with patient mobility, does not create pressure points, has
not previously been irradiated, does not show signs of infection, and does not
interfere with clothing. For arm port placement, site should be distal to the
desired vein insertion site. Consider the amount of cutaneous tissue over the
port septum, as excessive tissue will make access difficult. Conversely, too
thin a tissue layer over the port may lead to tissue erosion. A tissue thickness
of 0.5cm to 2cm is appropriate.
3. Complete patient implant record, including product reorder number and lot
number.
4. Perform adequate anesthesia.
5. Create sterile field and open tray.
6. Surgically prep and drape the implantation site.
7. For Attachable Catheters: Flush open-ended catheters with heparinized
saline and clamp the catheter closed several centimeters from the proximal
(port) end. Remember that some patients may be hypersensitive to heparin or
suffer from heparin induced thrombocytopenia (HIT) and these patients must
not have their port primed with heparinized saline. Note: Clamp catheter
segments that will be cut off prior to attachment.
CUT-DOWN PROCEDURE
1. Place patient in the Trendelenburg position with head turned away from the
intended venipuncture site. For arm port placement, position the arm in an
abducted, externally rotated position. Use a cut-down incision to expose the
entry vein of choice.
2. Perform vessel incision after vessel is isolated and stabilized to prevent
bleeding and air aspiration.
3. If using a vein pick, insert its tapered end through the incision and advance
it into the vessel. Then slide the catheter tip into the grooved underside of the
pick.
4. Advance the catheter tip into the vessel.
5. Withdraw the vein pick, if used.
6. Advance the catheter into the vessel to the desired infusion site.
Note: Catheters should be positioned with the catheter tip at the junction
of the superior vena cava and the right atrium. Verify correct catheter tip
position, using fluoroscopy, or appropriate technology. Do not occlude or cut
catheter when using sutures to secure catheter.
PERCUTANEOUS PROCEDURE
1. Place patient in the Trendelenburg position with head turned away from the
intended venipuncture site.
2. Locate desired vessel using a small gauge needle attached to a syringe. Refer
to the "Warnings" section covering catheter Pinch-off, if inserting the catheter
via the subclavian vein.
CATHETER
VESSEL
VEIN PICK
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