Arrow Arrowg+ard Blue Advance PICC Bedienungsanleitung Seite 2

6. Do not use excessive force when introducing guidewire,
peel-away sheath over tissue dilator, or tissue dilator as
this can lead to venospasm, vessel perforation, bleeding, or
component damage.
7. Passage of guidewire into the right heart can cause
dysrhythmias, right bundle branch block, and a perforation
of vessel, atrial or ventricular wall.
8. Do not apply excessive force in placing or removing catheter
or guidewire. Excessive force can cause component damage
or breakage. If damage is suspected or withdrawal cannot be
easily accomplished, radiographic visualization should be
obtained and further consultation requested.
9. Use only lumen(s) labeled "Pressure Injectable" for pressure
injection to reduce risk of catheter failure and/or patient
complications. Refer to the Arrow Pressure Injection
Information label for pressure injection information.
10. Do not secure, staple and/or suture directly to outside
diameter of catheter body or extension lines to reduce risk of
cutting or damaging the catheter or impeding catheter flow.
Secure only at indicated stabilization locations.
11. Air embolism can occur if air is allowed to enter a vascular
access device or vein. Do not leave open needles, sheaths, or
uncapped, unclamped catheters in central venous puncture
site. Use only securely tightened Luer-Lock connections with
any vascular access device to guard against inadvertent
disconnection.
12. Clinicians should be aware that slide clamps may be
inadvertently removed.
13. Clinicians must be aware of clinical conditions that may limit
use of PICCs including, but not limited to:
•
dermatitis
•
cellulitis and burns at or
about the insertion site
•
previous ipsilateral
venous thrombosis
•
radiation therapy at or
about insertion site
14. Clinicians must be aware of complications/undesirable side-
effects associated with PICCs including, but not limited to:
•
cardiac tamponade
secondary to vessel,
atrial, or ventricular
perforation
•
air embolism
•
catheter embolism
•
catheter occlusion
•
bacteremia
•
septicemia
•
extravasation
•
thrombophlebitis
Precautions:
1. Do not alter the catheter except as instructed. Do not alter
the guidewire or any other kit/set component during
insertion, use or removal.
2. Procedure must be performed by trained personnel well
versed in anatomical landmarks, safe technique and
potential complications.
3. Use standard precautions and follow institutional policies for
all procedures including safe disposal of devices.
4. Some disinfectants used at catheter insertion site contain
solvents which can weaken the catheter material. Alcohol,
•
contractures
•
mastectomy
•
potential use for AV
fistula
•
•
•
thrombosis
•
inadvertent arterial
puncture
•
nerve injury/damage
•
hematoma
•
bleeding/hemorrhage
•
fibrin sheath formation
•
exit site infection
•
vessel erosion
•
catheter tip malposition
•
dysrhythmias
•
SVC syndrome
•
phlebitis
•
anaphylaxis
acetone, and polyethylene glycol can weaken the structure
of polyurethane materials. These agents may also weaken
the adhesive bond between catheter stabilization device
and skin.
•
Do not use acetone on catheter surface.
•
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.
•
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, including prior to
pressure injection. Do not use syringes smaller than 10 mL
to reduce risk of intraluminal leakage or catheter rupture.
Power injector equipment may not prevent over pressurizing
an occluded or partially occluded catheter.
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: Use sterile technique.
Prep Puncture Site:
1. Prepare clean skin with appropriate antiseptic agent.
2. Drape puncture site.
3. Administer local anesthetic per institutional policies and procedures.
4. 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.).
•
Using one-handed technique, firmly push needles into disposal cup holes (refer to
Figure 1).
•
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:
Refer to Arrow® VPS® instructions for use for additional instructions regarding preparation of
VPS® Stylet (where provided). Refer to Arrow® VPS Rhythm® Device Operator' s Manual for
additional instructions regarding preparation of TipTracker™ Stylet (where provided).
2
Figure 1