Troubleshooting - Codman Hakim Bedienungsanleitung

adjoining finger to force fluid forward through the valve unit and drainage
catheter If necessary, repeat
Occasionally, it may be necessary to use a syringe with 25-gauge non-coring
needle to dislodge the obstruction Occlude the tubing proximal to the
prechamber Using light pressure, inject sterile, nonpyrogenic saline solution
into the prechamber (Figure 11)
To test the patency of the valve outlet or drainage catheter, press on the
pumping chamber If the pumping chamber resists compression, the valve
outlet or drainage catheter may be obstructed To dislodge the obstruction,
press the valve unit forcefully, then release it to permit the prechamber to
refill
(Non-cylindrical valves without SiphonGuard Device)
CAUTION: Flushing is not recommended as a method for determining
patency. Use clinical judgment and imaging studies or other techniques
to confirm suspected cases of shunt malfunction.
To flush the ventricular (proximal) catheter, occlude the catheter distal to
the reservoir with finger pressure, then depress the reservoir
To flush the distal catheter, occlude the catheter proximal to the reservoir
with finger pressure, then depress the reservoir
In general, if one pushes on the reservoir and it does not spring back,
then there might be an obstruction in the proximal catheter because the
reservoir is not filling with CSF On the other hand, if the reservoir feels
rather stiff and more force is needed to depress it, then the valve and/or
distal catheter may be clogged
Note: While proximal pressure is maintained, reservoir will not refill with
fluid
Note: Flushing the distal catheter cannot be performed with the right-angle
valve configuration

Troubleshooting

If valve function is adversely affected by accumulations of biological matter,
it may be possible to dislodge the material and restore proper function on
a valve without SiphonGuard by flushing and/or pumping the valve If this
remedial step fails to rectify the problem, replace the valve
Disposal
After patient use, the system must be handled as biohazardous material
and disposed of in accordance with applicable federal, state, local, or
international environmental requirements following facility protocols
APPENDIX
Preimplantation Performance Testing
Although Integra does not recommend functional testing, some
surgeons may choose to do so Before testing, it is extremely important
that a Codman Hakim Valve with or without SiphonGuard Device be
flushed of all air bubbles Air bubbles within the Codman Hakim Valve
or SiphonGuard Device produce inaccurate manometer test results The
presence of air bubbles can reduce the cross-sectional area of the flow
path, increase system resistance, and impede the flow of fluid through the
system during testing
SiphonGuard Device Functional Testing
Equipment required (use all sterile equipment, perform testing under
sterile conditions)
One manometer, wide-bore (e g 3 5 mm), graduated in mm (available in
lengths from 38 to 60 cm)
One 4-way stopcock
One syringe, 5 cc
One syringe filter, 5 µm
Tubing adapters
Silicone tubing
One male luer connector with 1/16 in barb
Saline solution
Flushing Procedure
Note: At a rate of 0 5 ml/minute, unitized versions require 2–3 minutes to
complete flushing This is the time required for fluid to fill the valve and exit
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