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Caution: Never use excessive force to advance/remove the
stylet as it may damage the device or result in patient injury.
C.
Prior to catheter insertion, ensure that the stylet tip is
contained within the catheter, but not more than 1 cm from
the trimmed end of the catheter, secure stylet within the
catheter manufacturer's Instructions.
Warning: Ensure that the stylet tip does not extend beyond
the trimmed end of the catheter. Extension of the stylet tip
beyond the catheter end combined with kinking and excessive
forces may result in vessel damage, stylet damage, difficult
removal, stylet tip separation, potential embolism and risk
patient injury.
D. Attach saline-filled syringe and flush catheter.
E.
Remove the syringe after flushing.
6.
Catheter Insertion
A.
Perform ultrasound and locate vessel. Follow ultrasound system
Instructions for Use.
B.
Follow catheter Instructions for Use regarding Venous Access
and Catheter Insertion.
C.
Connect the end of the ECG Clip Cable (provided in the ECG
Cable Accessory Pack) through the drape window to the ECG
patient hub.
Note: C3 Wave™ only works with conductive [metal] stylets.
- Secure the ECG Clip Cable (alligator clamp) to the
proximal end of the stylet.
D.
Place C3 Wave™ System monitor in 'Internal Mode' and insert
catheter per manufacturer's Instructions for Use.
E.
Flush catheter with saline and wait for intravascular ECG
waveform to stabilize on monitor screen.
F.
Verify that the P-wave on the intravascular ECG waveform is
present, identifiable, and consistent on monitor screen.
F.
Verify that the P-wave on the intravascular ECG waveform is
present, identifiable, and consistent on monitor screen.
Warning: Do not rely on ECG signal detection for Catheter tip
positioning when interpretation of the P-wave is difficult. For
example, when:
a.
P-wave is not present
b. P-wave is not identifiable
c.
P-wave is intermittent
7.
Catheter Tip Guidance and Positioning
The following figures show approximate catheter tip positions and
representative intravascular ECG waveforms.
Figure 1: No evident P wave change - catheter tip is not in an
acceptable position.
Figure 2: P wave at its maximum height - catheter tip is in the lower
1/3 of superior vena cava/right atrial junction.
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