MedComp PRO-PICC CT Instrucciones De Uso página 6

locking collar to keep stylet in place.
9. Remove dilator from sheath.
10. Insert distal tip of catheter into and through the sheath until catheter tip is
correctly positioned in the target vein.
11. Remove the tear-away sheath by slowly pulling it out of the vessel while simul-
taneously splitting the sheath by grasping the tabs and pulling them apart
(a slight twisting motion may be helpful).
Caution: DO NOT pull apart the portion of the sheath that remains in the vessel.
To avoid vessel damage, pull back the sheath as far as possible and tear the
sheath only few centimeters at a time.
12. Make any adjustments to catheter under fluoroscopy. The distal tip should be
positioned at the level of the caval atrial junction.
Caution: DO NOT clamp the lumen portion of the catheter.
13. Loosen locking collar of sideport. Remove the stylet by applying gentle pres-
sure with one hand above the insertion site while grasping the stylet with the
other hand and slowly pulling back with a constant motion. Remove sideport
adapter and replace with needleless access port. Attach saline filled syringe
to needleless access port, aspirate lumen and then irrigate with saline.
Caution: If difficulty and/or bunching of the catheter lumen are experienced while
removing the stylet, additional flushing of the catheter may be helpful. The catheter
may need to be repositioned to allow for removal of the stylet.
Caution: DO NOT attempt to reinsert stylet once it has been withdrawn.
Caution: Never leave stylet in place after catheter insertion; injury may occur.
Remove both stylet and sideport adapter after insertion.
14. Attach syringe(s) to extension(s). Blood should aspirate easily. If excessive
resistance to blood aspiration is experienced, the catheter may need to be
repositioned to obtain adequate flow.
15. Once adequate aspiration has been achieved, lumen(s) should be irrigated
with saline filled syringe(s).
Caution: Small syringes will generate excessive pressure and may damage the
catheter. Ten (10)cc or larger syringes are recommended.
16. Remove the syringe(s). Avoid air embolism by aspirating then irrigating the
catheter with saline prior to each use. With each change in tubing connec-
tions, purge air from the catheter and all connecting tubing and caps.
17. Confirm and document proper tip placement with fluoroscopy prior to use.
The distal tip should be positioned at the level of the caval atrial junction.
Caution: Failure to verify catheter placement may result in serious trauma or fatal
complications.
Note: If there is no blood return, verify catheter position before use.
CATHETER SECUREMENT AND WOUND DRESSING:
• The insertion site and external portion of the catheter should always be covered
with a protective dressing.
18. Cover the exit site with an occlusive dressing according to the facility policy.
19. Record catheter length, catheter lot number, and tip position on patient's
chart.
1. Follow directions for Modified Seldinger Insertion, up to Step #5.
2. Remove needle, leaving guidewire in the targeted vein. Advance the guidewire
until it reaches the caval atrial junction. Once the guidewire is in place, measure
the depth of the guidewire by reading the markings on the wire.
3. Cut catheter to length determined by marked guidewire.
4. Insert proximal end of wire into distal tip of catheter lumen. Feed catheter
lumen into the vessel following the guidewire. Advance catheter lumen along
the guidewire until the distal tip is correctly positioned in the target vein.
The distal tip should be positioned at the level of the caval atrial junction.
Caution: A skin knick may be required to feed the catheter smoothly into the vessel.
5. Make any adjustments to catheter under fluoroscopy. The distal tip should be
positioned at the level of the caval atrial junction.
Caution: DO NOT clamp the lumen portion of the catheter.
6. Remove the wire from the catheter. Remove by applying gentle pressure with
one hand above the insertion site while grasping the 130cm wire with the other
hand and pulling slowly back with a constant motion.
7. Follow Directions for Modified Seldinger Insertion, from Step #14 on.
1. Remove the injection/needleless cap from the PRO-PICC
2. Using a 10cc or larger syringe(s), aspirate catheter lumen(s) to assure patency
and remove heparin. Discard syringe(s).
3. Attach a 10cc or larger syringe filled with sterile normal saline and vigorously
flush the catheter with the full 10cc of sterile normal saline.
DIRECTIONS FOR SELDINGER INSERTION
POWER INJECTION PROCEDURE
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CT catheter.
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