Inhaltsverzeichnis
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•
The heparin solution must be removed from each lumen prior to treatment to avoid systemic heparinization of the patient. Aspiration should be based on
institutional protocol.
•
Before dialysis begins, all connections to the catheter and extracorporeal circuits should be examined carefully.
•
Accessories and components used in conjunction with this catheter should incorporate luer-lock adapters.
•
Frequent visual inspection should be conducted to detect leaks and to minimize blood loss or air embolism.
•
Repeated over-tightening of blood lines, syringes and caps will reduce connector life and could lead to potential connector failure.
•
If a leak in the catheter tubing or hub occurs, or if a connector separates from any component during insertion or use, clamp the catheter and take all necessary
steps and precautions to prevent blood loss or air embolism.
•
To minimize the risk of air embolism, keep the catheter clamped at all times when not attached to a syringe, IV tubing, or bloodlines.
•
Close all clamps in the center of the extension tubing. Repeated clamping near or on the luer lock connectors may cause tubing fatigue and possible
disconnection.
•
Clamping of the tubing repeatedly in the same location may weaken the tubing. Extension tubing may develop cuts or tears if subjected to excessive pulling or
contact with rough edges.
POST DIALYSIS HEPARINIZATION
Follow institutional protocol for heparin concentration. If the catheter is not to be used immediately for treatment, follow the suggested catheter patency guidelines.
1.
Draw the heparin / saline solution into two syringes, corresponding to the amount designated on the arterial and venous extension tubing clamp. Assure that the
syringes are free of air.
2.
Attach a syringe containing heparin solution.
3.
Open the extension tubing clamp.
4.
Aspirate to ensure that no air will be forced into the patient.
5.
Inject the heparin solution into each lumen using a quick bolus technique.
PRECAUTION: To maintain patency between treatments, a heparin lock must be created in each lumen of the catheter.
6.
Close extension clamps.
PRECAUTION: Extension clamps should only be open for aspiration, flushing, and dialysis treatment.
7.
Remove syringes.
PRECAUTION: In most instances, no further heparin flush will be necessary for 48-72 hours, provided the lumens have not been aspirated or flushed.
8.
Assure luers are capped.
CATHETER PERFORMANCE PRIMING VOLUMES
•
The priming volumes of both the arterial and
venous lumens are printed on each extension
tubing clamp.
FLOW RATE
•
Typical flow rate vs. pressure with the ProGuide
14.5 FR X 28 cm (tip to hub) catheter
(with side holes)
TROUBLESHOOTING INSUFFICIENT FLOWS
Treatment for insufficient flow will be at the
discretion of the physician. Excessive force should
not be used to flush an obstructed lumen.
Insufficient blood flow may be caused by an
occluded lumen due to clotting or fibrin sheath
or because the arterial hole is contacting the vein
wall. If manipulation of the catheter or reversing
arterial and venous lines does not help, the
physician may attempt to dissolve the clot with a
thrombolytic agent.
MANAGEMENT OF ONE-WAY OBSTRUCTIONS
One-way obstructions exist when a lumen can be flushed easily but blood cannot be aspirated. This condition is usually caused by tip malposition. One of the following
adjustments may resolve the obstruction:
•
Reposition the catheter
•
Reposition the patient
•
Have the patient cough
•
Provided there is no resistance, flush the catheter vigorously with sterile normal saline to try to move the tip away from the vessel wall.
INFECTION
Catheter related infection is a serious concern of indwelling catheters. Follow institutional protocol when removing the catheter.
SYMBOL
Single Use
Caution - Federal Law (USA) restricts this device to sale by or on the order of a physician.
Sterilized Using Ethylene Oxide
Do Not Use if Package is Damaged
Non-pyrogenic
Caution: Consult accompanying documents. Read instructions prior to use.
Flow Rate vs Pressure
M I L L I L I T E R S P E R M I N U T E
DESIGNATION
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Inhaltsverzeichnis
