MedComp SPLIT CATH Gebrauchsanleitung Seite 7

7. Split the arterial and venous lumens by grasping the distal ends and
gently pull apart the lumens to the point printed "DO NOT SPLIT
BEYOND THIS POINT".
Warning: Splitting the lumens beyond this point may result in
excess tunnel bleeding, infection, or damage to the catheter lumens.
Also use caution to avoid damaging the stylets when splitting the
lumens.
8. Push stylets back into catheter and tighten stylet cap onto arterial
and venous catheter luers. Thread stylet tip into proximal hole of
venous lumen and out the tip hole to allow the stylet tip to extend
beyond the venous tip.
9. Tighten both stylets onto luers.
10. Insert the introducer needle with attached syringe, or One-Step™
bulb needle, into the target vein. Aspirate to insure proper
placement. When using the One-Step™, fill the bulb with saline.
Once bulb is fully primed with no air present, squeeze bulb with
thumb and forefinger. Continue to squeeze bulb until needle is under
patient's skin. Once target vein is located, blood will flash back into
flexible chamber.
11. Remove the syringe, (see 11a for One- Step™ Directions), and place
thumb over the end of the needle to prevent blood loss or air
embolism. Draw flexible end of guidewire back into advancer so
that only the end of the guidewire is visible. Insert advancer's distal
end into the needle hub. Advance guidewire with forward motion
into and past the needle hub into the target vein.
11a. One-Step™ Directions: Once blood has been aspirated into the
flexible bulb, draw flexible end of guidewire back into advancer so
that only the end of the guidewire is visible. Insert advancer's distal
end into the One- Step™ bulb needle. 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.
12. Remove needle, leaving guidewire in the target vein. Enlarge
cutaneous puncture site with scalpel.
13. Thread dilator(s) over guidewire into the vessel (a slight twisting
motion may be used). Remove dilator(s) when vessel is sufficiently
dilated, leaving guidewire in place.
Caution: Insufficient tissue dilation can cause compression of the
catheter lumen against the guidewire causing difficulty in the insertion
and removal of the guidewire from the catheter. This can lead to bending
of the guidewire.
Caution: Do not leave vessel dilator(s) in place as an indwelling catheter
to avoid possible vessel wall perforation.
14. Thread the proximal end of the guidewire through the distal tip of
the stylet.
15. Once the guidewire exits through the red luer connector, hold the
guidewire securely and advance the catheter over the guidewire
and into the target vein, making sure to hold the arterial and
venous tips securely to prevent the venous lumen from kinking and
the stylet tip from retracting into the catheter during insertion.
Caution: Do not advance guidewire with catheter into vein. Cardiac
arrhythmias may result if guidewire is allowed to pass into the right
atrium. The guidewire should be held securely during this procedure.
16. Remove the guidewire and stylets, leaving catheter in place.
17. Make any adjustments to catheter under fluoroscopy. The distal
venous tip should be positioned at the level of the caval atrial
junction or into the right atrium to ensure optimal blood flow.
Note:
Femoral catheter tip placement is recommended at the junction
of the iliac vein and the inferior vena cava.
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