Codman MedStream Gebrauchsanweisung Seite 6

1. Aspirate drug solution from the bolus channel and catheter(s)
a. Use the MedStream Control Unit to interrogate the pump. Scroll to the
catheter information section (the second page of the summary screens).
If a one-piece catheter system was used, make note of the "Implanted
Catheter Volume." If a two-piece catheter system was used, make note
of the "Total Catheter Volume." Refer to the MedStream Infusion System
Programming Guide for more information.
b. Connect one 10 mL syringe to the stopcock at the end of the connecting
tube. Connect the bolus needle to the other end of the connecting tube.
c. Palpate the pump and locate the central port and the bolus port (next to
the pump outlet). Fluoroscopy can be used to assist in locating the
bolus port.
d. Disinfect a wide area of skin over and around the bolus port; cover the
prepared area with a sterile fenestrated drape.
e. Holding the bolus needle perpendicular to the pump, puncture the bolus
port. Insert the bolus needle until it contacts the needle stop; twist the
needle to ensure it penetrates the silicone bolus channel beneath the
bolus port.
f. With gentle negative pressure, aspirate an amount of drug solution equal to
the volume of the catheter(s).
g. Close the stopcock of the connecting tube and remove the syringe,
leaving the connecting tube and bolus needle in place.
h. Dispose of the aspirated drug solution and syringe in an
appropriate manner.
2. Set up for bolus administration
a. Connect the unused 10 mL syringe to an aspiration needle.
b. Using the aspiration needle, draw the prepared drug solution into the
syringe. Expel the air from the syringe.
c. Remove the aspiration needle. Connect the syringe to the filter.
d. Expel the air from the filter.
e. Connect the filter to the connecting tube.
3. Injecting the bolus
a. Open the stopcock on the connecting tube and slowly inject the
drug solution.
WARNING: Do not exceed an injection speed of 5 mL/minute
during bolus injection of drug solution or any fluid, including saline.
Injection into the bolus port under high pressure may cause catheter
disconnection or catheter damage and subsequent fluid leakage.
b. Close the stopcock of the connecting tube and remove the syringe from
the filter. Rinse the syringe with sterile water or sterile saline and retain for
use in flushing the bolus channel (Step 4).
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4. Gently flush the bolus channel
a. Connect the syringe to an aspiration needle. Draw 5 mL of saline into the
syringe; expel the air.
b. Remove the aspiration needle. Connect the syringe to the filter on the
connecting tube.
c. Open the stopcock and slowly (over one full minute) inject the saline to
gently flush the bolus channel.
5. Remove the bolus needle from the bolus port and, if necessary, cover the
injection site with a self-adhesive sterile bandage.
If you are unable to inject into the bolus port...
• The bolus needle may not have been inserted completely.
Ensure that the bolus port is punctured and that the bolus needle is inserted
perpendicularly until it contacts the needle stop; then twist the needle.
Twisting the needle during insertion helps ensure that it penetrates the
silicone bolus channel beneath the bolus port.
• The bolus needle may be clogged.
Remove the bolus needle and check its function.
• The catheter may be bent, kinked, or clogged.
Use radiography to ensure the catheter is not occluded due to being bent
or kinked.
CAUTION: When injecting contrast media intrathecally, use only contrast
medium indicated for intrathecal administration. Failure to do so may result
in adverse events such as extreme pain, cramps, seizures, and death.
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