Teleflex ARROW ZVK Bedienungsanleitung Seite 2

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Do not use alcohol to soak catheter surface or allow
alcohol to dwell in a catheter lumen to restore catheter
patency or as an infection prevention measure.
•
Do not use polyethylene glycol containing ointments at
insertion site.
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Take care when infusing drugs with a high concentration
of alcohol.
•
Allow insertion site to dry completely prior to applying
dressing.
5. Ensure catheter patency prior to use. Do not use syringes
smaller than 10 mL (a fluid filled 1 mL syringe can exceed 300
psi) to reduce risk of intraluminal leakage or catheter rupture.
6. Minimize catheter manipulation throughout procedure to
maintain proper catheter tip position.
Kits/Sets may not contain all accessory components
detailed in these instructions for use. Become familiar with
instructions for individual component(s) before beginning
the procedure.
A Suggested Procedure:
Prep Puncture Site:
1. Position patient as appropriate for insertion site.
• Subclavian or Jugular approach: Place patient in slight Trendelenburg position as
tolerated to reduce risk of air embolism and enhance venous filling.
• Femoral approach: Place patient in supine position.
2. Prepare clean skin with an appropriate antiseptic agent.
3. Drape puncture site.
4. Administer local anesthetic per institutional policies and procedures.
5. Dispose of needle.
SharpsAway® II Locking Disposal Cup (where provided):
The SharpsAway II Locking Disposal Cup is used for disposal of needles (15 Ga. - 30 Ga.).
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Using one-handed technique, firmly push needles into disposal cup holes (refer to
Figure 1).
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Once placed into disposal cup, needles will be automatically secured in place so that
they cannot be reused.
Precaution: Do not attempt to remove needles that have been placed into
SharpsAway II Locking Disposal Cup. These needles are secured in place. Damage
may occur to needles if they are forced out of disposal cup.
•
Where provided, a foam SharpsAway system may be utilized by pushing needles into
foam after use.
Precaution: Do not re-use needles after they have been placed into the foam
SharpsAway system. Particulate matter may adhere to needle tip.
Prepare Catheter:
6. Flush each lumen with sterile normal saline for injection to establish patency and
prime lumen(s).
7. Clamp or attach Luer-Lock connector(s) to extension line(s) to contain saline within
lumen(s).
8. Leave distal extension line uncapped for guidewire passage.
Warning: Do not cut catheter to alter length.
Use sterile technique.
Figure 1
Gain Initial Venous Access:
Echogenic Needle (where provided):
An echogenic needle is used to allow access to the vascular system for the introduction of a
guidewire to facilitate catheter placement. The needle tip is enhanced for approximately 1 cm
for clinician to identify exact needle tip location when puncturing the vessel under ultrasound.
Protected Needle/Safety Needle (where provided):
A protected needle/safety needle should be used in accordance with manufacturer's
instructions for use.
Arrow® Raulerson Syringe (where provided):
Arrow Raulerson Syringe is used in conjunction with Arrow Advancer for guidewire insertion.
9. Insert introducer needle or catheter/needle with attached syringe or Arrow Raulerson
Syringe (where provided) into vein and aspirate.
Warning: Do not leave open needles or uncapped, unclamped catheters in
central venous puncture site. Air embolism can occur if air is allowed to enter a
central venous access device or vein.
Precaution: Do not reinsert needle into introducer catheter (where provided) to
reduce risk of catheter embolus.
Verify Venous Access:
Utilize one of the following techniques to verify venous access because of the potential for
inadvertent arterial placement:
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Central Venous Waveform:
• Insert fluid primed blunt tip pressure transduction probe into rear of plunger
and through valves of Arrow Raulerson Syringe and observe for central venous
pressure waveform.
◊ Remove transduction probe if using Arrow Raulerson Syringe.
•
Pulsatile Flow (if hemodynamic monitoring equipment is not available):
• Use transduction probe to open syringe valving system of Arrow Raulerson Syringe
and observe for pulsatile flow.
• Disconnect syringe from needle and observe for pulsatile flow.
Warning: Pulsatile flow is usually an indicator of inadvertent arterial puncture.
Precaution: Do not rely on blood aspirate color to indicate venous access.
Insert Guidewire:
Guidewire:
Kits/Sets are available with a variety of guidewires. Guidewires are provided in different
diameters, lengths and tip configurations for specific insertion techniques. Become familiar
with the guidewire(s) to be used with the specific technique before beginning the actual
insertion procedure.
Arrow® GlideWheel™ Wire Advancer or Arrow Advancer
(where provided):
Arrow Advancer is used to straighten "J" Tip of guidewire for introduction of the guidewire
into Arrow Raulerson Syringe or a needle.
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Using thumb, retract "J" (refer to Figure 2 GlideWheel or 2A Standard Advancer
depending on which Arrow Advancer is provided).
2A.
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Place tip of Arrow Advancer – with "J" retracted – into the hole in rear of Arrow
Raulerson Syringe plunger or introducer needle.
2
Figure 2