MedComp Split Cath III Instrucciones De Uso página 6

Warning: Do not over-expand subcutaneous tissue during tunneling.
Over-expansion may delay/prevent cuff in-growth.
10. Lead catheter into the tunnel gently. Do not pull or tug the catheter
tubing. If resistance is encountered, further blunt dissection may
facilitate insertion. Remove the catheter from the trocar and sleeve.
Caution: Do not pull tunneler out at an angle. Keep tunneler straight to
prevent damage to catheter tip.
Note: A tunnel with a wide gentle arc lessens the risk of kinking. The
tunnel should be short enough to keep the Y-hub of the catheter from
entering the exit site, yet long enough to keep the cuff 2cm (minimum)
from the skin opening.
11. Split the arterial and venous lumens by grasping the distal ends and
gently pull apart the lumens to the point printed "DO NOT SPLIT
BEYOND THIS POINT".
Warning: Splitting the lumens beyond this point may result in
excess tunnel bleeding, infection, or damage to the catheter lumens.
Also use caution to avoid damaging the stylet when splitting the
lumens.
12. Push stylet back into catheter and tighten stylet cap onto arterial
catheter luer. Thread stylet tip into proximal hole of venous lumen
and out the tip hole to allow the stylet tip to extend beyond the
venous tip.
13. Irrigate catheter with saline, then clamp venous extension and
cap stylet to assure that saline is not inadvertently drained from
lumens. Use clamp and injection cap provided.
Caution: The length of the wire inserted is determined by the size of the
patient. Monitor patient for arrhythmia throughout this procedure. The
patient should be placed on a cardiac monitor during this procedure.
Cardiac arrhythmias may result if guidewire is allowed to pass into the
right atrium. The guidewire should be held securely during this
procedure.
14. Remove needle, leaving guidewire in the target vein. Enlarge
cutaneous puncture site with scalpel.
15. Thread dilator(s) over guidewire into the vessel (a slight twisting
motion may be used). Remove dilator(s) when vessel is sufficiently
dilated, leaving guidewire in place.
Caution: Insufficient tissue dilation can cause compression of the
catheter lumen against the guidewire causing difficulty in the insertion
and removal of the guidewire from the catheter. This can lead to bending
of the guidewire.
Caution: Do not leave vessel dilator(s) in place as an indwelling catheter
to avoid possible vessel wall perforation.
16. Thread the proximal end of the guidewire through the distal tip of
the stylet.
17. Once the guidewire exits through the red luer connector, hold the
guidewire securely and advance the catheter over the guidewire and
into the target vein, making sure to hold the arterial and venous
tips securely to prevent the venous lumen from kinking and the
stylet tip from retracting into the catheter during insertion.
Caution: Do not advance guidewire with catheter into vein. Cardiac
arrhythmias may result if guidewire is allowed to pass into the right
atrium. The guidewire should be held securely during this procedure.
18. Remove the guidewire and stylet, leaving catheter in place.
19. Make any adjustments to catheter under fluoroscopy.
20. Attach syringes to both extensions and open clamps. Blood should
aspirate easily from both arterial and venous sides. If either side
exhibits excessive resistance to blood aspiration, the catheter may
need to be rotated or repositioned to obtain adequate blood flows.
21. Once adequate aspiration has been achieved, both lumens should
be irrigated with saline filled syringes using quick bolus technique.
Assure that extension clamps are open during irrigation procedure.
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