MedComp HEMO-FLOW Gebrauchsanleitung Seite 7

5. Use blunt dissection to create the subcutaneous tunnel
opening. Attach the catheter to the trocar (a slight twisting
motion may be helpful). Slide catheter tunneling sleeve over the
catheter making certain that the sleeve covers the arterial holes
of the catheter. Insert the trocar into the exit site and create a
short subcutaneous tunnel. Do not tunnel through muscle. The
tunnel should be made with care in order to prevent damage to
surrounding vessels.
5a. For Femoral Vein Insertion: Create subcutaneous tunnel with
the catheter exit site in the pelvic region.
Warning: Do not over-expand subcutaneous tissue during
tunneling. Over-expansion may delay/prevent cuff in-growth.
6. Lead catheter into the tunnel gently. Do not pull or tug the
catheter tubing. If resistance is encountered, further blunt
dissection may facilitate insertion. Remove the catheter from
the trocar with a slight twisting motion to avoid damage to the
catheter.
Caution: Do not pull tunneler out at an angle. Keep tunneler
straight to prevent damage to catheter tip.
Note: A tunnel with a wide gentle arc lessens the risk of kinking.
The tunnel should be short enough to keep the Y-hub of the catheter
from entering the exit site, yet long enough to keep the cuff 2cm
(minimum) from the skin opening.
7. Irrigate catheter with saline, then clamp catheter extensions to
assure that saline is not inadvertenly drained from lumens. Use
clamps provided.
8. Insert the introducer needle with attached syringe, or into the
target vein. Aspirate to insure proper placement.
9. Remove the syringe, 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.
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.
10. Remove needle, leaving guidewire in the target vein. Enlarge
cutaneous puncture site with scalpel.
11. Thread Vascu-Sheath
guidewire. Once the Vascu-Sheath
vein, remove the guidewire leaving the sheath and dilator in
position.
introducer over the proximal end of the
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introducer is in the target