Arrow Arrowg+ard Blue Advance PICC Bedienungsanleitung Seite 3

Trim Catheter if Required:
Warning: Infusion of incompatible drugs through adjacent exit ports may cause
precipitation and/or occlusion.
5. Retract contamination guard.
6. Use centimeter marks on catheter body to trim catheter to desired length based on
patient size and desired point of insertion.
Where Side-port connector and placement wire are provided follow
steps 7 and 8.
7. Withdraw placement wire through septum to retract wire a minimum of 4 cm behind
catheter cut location (refer to Figure 2).
Tip of wire
Wire retracted
4 cm (min)
8. Kink proximal end of placement wire at side-port connector to minimize risk of
placement wire exiting distal tip of catheter during insertion (refer to Figure 3).
Warning: Do not attempt to advance placement wire through septum.
Catheter Trimmer (where provided):
A catheter trimmer is a one-time use trimming device.
• Insert catheter into hole on trimmer to desired cut location.
•
Depress blade to cut catheter.
NOTE: Resistance when cutting catheter is likely caused by insufficiently retracted
placement wire. Do not use catheter if placement wire has not been retracted.
9. Cut catheter straight across (90° to catheter cross-section) using trimming device
(where provided) to maintain a blunt tip.
Warning: Do not cut placement wire when trimming catheter to reduce risk of
damage to placement wire, wire fragment, or embolism.
10. Inspect cut surface for clean cut and no loose material.
Precaution: Check that there is no wire in cut catheter segment after trimming.
If there is any evidence that placement wire has been cut or damaged, the
catheter and placement wire should not be used.
Flush Catheter:
11. Flush each lumen with sterile normal saline for injection to establish patency and
prime lumen(s).
12. Clamp or attach Luer-Lock connector(s) to extension line(s) to contain saline within
lumen(s).
Warning: Do not clamp extension line when placement wire is in catheter to
reduce risk of placement wire kinking.
Warning: Do not clamp extension line in close proximity of the extension line
hub to reduce the risk of component damage.
Length of catheter
to be trimmed
Tip of catheter
Figure 2
Figure 3
Gain Initial Venous Access:
13. Apply tourniquet and replace sterile gloves.
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.
14. Insert introducer needle or catheter/needle into vein.
Precaution: Do not reinsert needle into introducer catheter (where provided) to
reduce risk of catheter embolus.
15. Check for non-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 33 or 45 cm Guidewire (Access Wire):
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 chosen before beginning the actual insertion
procedure.
Arrow Advancer (where provided):
Arrow Advancer is used to introduce guidewire into a needle.
•
Using thumb, retract guidewire tip. Place tip of Arrow Advancer – with guidewire
retracted – into introducer needle (refer to Figure 4).
16. Advance guidewire into introducer needle.
Warning: Do not insert stiff end of guidewire into vessel as this may result in
vessel damage.
17. Raise thumb and pull Arrow Advancer approximately 4 - 8 cm away from introducer
needle. Lower thumb onto Arrow Advancer and while maintaining a firm grip on
guidewire, push assembly into needle to further advance guidewire. Continue until
guidewire reaches desired depth.
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 withdraw guidewire against needle bevel to reduce risk of
possible severing or damaging of guidewire.
18. Remove introducer needle (or catheter) while holding guidewire in place.
Insert Catheter:
Refer to Arrow VPS instructions for use for additional instructions regarding insertion using
VPS Stylet (where provided). Refer to Arrow VPS Rhythm Device Operator' s Manual for
additional instructions regarding insertion using TipTracker Stylet (where provided).
Insertion using Peel-Away Sheath:
19. Ensure dilator is in position and locked to hub of sheath.
20. Thread peel-away sheath/dilator assembly over guidewire.
21. Grasping near skin, advance peel-away sheath/dilator assembly over guidewire with
3
Figure 4