Teleflex ARROW ZVK Bedienungsanleitung Seite 3

3A.
10. Advance guidewire into Arrow Raulerson Syringe approximately 10 cm until it passes
through syringe valves or into introducer needle.
• Advancement of guidewire through Arrow Raulerson Syringe may require a gentle
twisting motion.
• If using Arrow GlideWheel Advancer, advance guidewire through the Arrow
Raulerson Syringe or through the introducer needle by pushing advancer wheel
and guidewire forward (refer to Figure 3). Continue until guidewire reaches desired
depth.
• If using standard Arrow Advancer, raise thumb and pull Arrow Advancer
approximately 4 - 8 cm away from Arrow Raulerson Syringe or introducer needle.
Lower thumb onto Arrow Advancer and while maintaining a firm grip on guidewire,
push assembly into syringe barrel to further advance guidewire (refer to Figure 3A).
Continue until guidewire reaches desired depth.
11. Use centimeter markings (where provided) on guidewire as a reference to assist in
determining how much guidewire has been inserted.
NOTE: When guidewire is used in conjunction with Arrow Raulerson Syringe (fully
aspirated) and a 2-1/2" (6.35 cm) introducer needle, the following positioning
references can be made:
• 20 cm mark (two bands) entering back of plunger = guidewire tip at end
of needle
• 32 cm mark (three bands) entering back of plunger = guidewire tip
approximately 10 cm beyond end of needle
Precaution: Maintain firm grip on guidewire at all times. Keep sufficient
guidewire length exposed for handling purposes. A non-controlled guidewire
can lead to wire embolus.
Warning: Do not aspirate Arrow Raulerson Syringe while guidewire is in place;
air may enter syringe through rear valve.
Precaution: Do not reinfuse blood to reduce risk of blood leakage from rear (cap)
of syringe.
Warning: Do not withdraw guidewire against needle bevel to reduce risk of
possible severing or damaging of guidewire.
12. Remove introducer needle and Arrow Raulerson Syringe (or catheter) while holding
guidewire in place.
13. Use centimeter markings on guidewire to adjust indwelling length according to
desired depth of indwelling catheter placement.
14. If necessary, enlarge cutaneous puncture site with cutting edge of scalpel, positioned
away from guidewire.
Warning: Do not cut guidewire to alter length.
Warning: Do not cut guidewire with scalpel.
• Position cutting edge of scalpel away from guidewire.
• Engage safety and/or locking feature of scalpel (where provided) when not in
use to reduce the risk of sharps injury.
15. Use tissue dilator to enlarge tissue tract to the vein as required. Follow the angle of the
guidewire slowly through the skin.
Warning: Do not leave tissue dilator in place as an indwelling catheter. Leaving
tissue dilator in place puts patient at risk for possible vessel wall perforation.
Figure 3
Advance Catheter:
16. Thread tip of catheter over guidewire. Sufficient guidewire length must remain
exposed at hub end of catheter to maintain a firm grip on guidewire.
17. Grasping near skin, advance catheter into vein with slight twisting motion.
Warning: Do not attach catheter clamp and fastener (where provided) until
guidewire is removed.
18. Using centimeter marks on catheter as positioning reference points, advance catheter
to final indwelling position.
NOTE: Centimeter marking symbology is referenced from catheter tip.
• numerical: 5, 15, 25, etc.
• bands: each band denotes a 10 cm interval, with one band indicating 10 cm, two
bands indicating 20 cm, etc.
• dots: each dot denotes a 1 cm interval
19. Hold catheter at desired depth and remove guidewire.
Precaution: If resistance is encountered when attempting to remove guidewire
after catheter placement, guidewire may be kinked around tip of catheter
within vessel (refer to Figure 4).
• In this circumstance, pulling back on guidewire may result in undue force being
applied resulting in guidewire breakage.
• If resistance is encountered, withdraw catheter relative to guidewire about 2-3 cm
and attempt to remove guidewire.
• If resistance is again encountered, remove guidewire and catheter simultaneously.
Warning: Do not apply undue force on guidewire to reduce risk of possible
breakage.
20. Always verify entire guidewire is intact upon removal.
Complete Catheter Insertion:
21. Check lumen patency by attaching a syringe to each extension line and aspirate until
free flow of venous blood is observed.
22. Flush lumen(s) to completely clear blood from catheter.
23. Connect all extension line(s) to appropriate Luer-Lock connector(s) as required.
Unused port(s) may be "locked" through Luer-Lock connector(s) using standard
institutional policies and procedures.
• Slide clamp(s) are provided on extension lines to occlude flow through each lumen
during line and Luer-Lock connector changes.
Warning: Open slide clamp prior to infusion through lumen to reduce risk of
damage to extension line from excessive pressure.
Secure Catheter:
24. Use a catheter stabilization device, catheter clamp and fastener, staples or sutures
(where provided).
• Use catheter hub as primary securement site.
• Use catheter clamp and fastener as a secondary securement site as necessary.
Precaution: Minimize catheter manipulation throughout procedure to maintain
proper catheter tip position.
Catheter Stabilization Device (where provided):
A catheter stabilization device should be used in accordance with manufacturer's
instructions for use.
Catheter Clamp and Fastener (where provided):
A catheter clamp and fastener are used to secure catheter when an additional securement
site other than the catheter hub is required for catheter stabilization.
•
After guidewire has been removed and necessary lines have been connected or locked,
spread wings of rubber clamp and position on catheter making sure catheter is not
moist, as required, to maintain proper tip location.
•
Snap rigid fastener onto catheter clamp.
•
Secure catheter clamp and fastener as a unit to patient by using either catheter
3
Figure 4