Codman EDS 3 Manual De Instrucciones página 6

Monitoring ICP
WARNING: MONITORING ICP WITH A STOPCOCK IN THE NULL
POSITION MAY RESULT IN FALSE ICP READINGS. SIMULTANEOUS
DRAINAGE AND TRANSDUCER MONITORING MAY RESULT IN
WAVEFORM ARTIFACTS AND ARTIFICIALLY LOW ICP READINGS
AS DESCRIBED BY WILKINSON
MONITORING CAN BE ACHIEVED BY ADJUSTING THE STOPCOCKS
TO EITHER THE DRAINAGE ONLY POSITION FOR DRAINAGE OR THE
MONITORING ONLY POSITION FOR ICP MONITORING.
Monitor ICP from either the patient line stopcock or the system stopcock.
ICP monitoring is accomplished by connecting the ICP monitoring
equipment (i.e., fluid coupled transducer), to the desired stopcock and
placing the stopcock in the Monitoring Only position.
Note: Always refer to the manufacturer's instructions for proper leveling and
operation of an ICP monitoring transducers and equipment.
Using the Needle-Free Sampling/Injection Site
WARNING: The EDS 3 System provides direct access to the ventricular
drainage catheter via the patient line stopcock and the needle-free
injection site. Care must be taken when administering medication
through these locations to minimize the chance of intravascular
medications being injected into the cerebrospinal fluid.
CAUTION: Do not attempt to access the silicone seal of the needle-
free injection/sampling site using a needle or blunt cannula. To
prevent damage to the seal, access using standard Luer connection
devices only.
A. Injecting Medication into the System
Medication can be administered to the patient via the needle-free sampling/
injection site on the Y-connector, which is part of the patient line. Follow this
procedure to administer medication via this site:
1. Rotate the patient line stopcock until it is in the Drainage Only position
and close the slide clamp immediately distal to the Y-connector.
(Note: Slide clamps are provided if a double-clamping technique
is utilized.)
2. Swab the silicone seal of the injection site with 70% isopropyl alcohol
prior to use. Allow to dry for 1 minute.
3. Use a male slip luer syringe or a male luer lock syringe. Grasp the
injection site and firmly push and twist the syringe clockwise onto the
injection site until tight. Administer the medication. (Note: The capacity
of the patient line and ventricular catheter, from the injection site to the
proximal tip of the catheter, is approximately 1.5 cc.)
4. To disconnect, twist the syringe counterclockwise until loose. When the
syringe is removed, the injection site is closed; do not cap.
5. Flush the site in accordance with the facility's protocol.
6. Reopen the clamp(s) after injection to resume drainage.
B. Sampling Fluid From the Needle-Free Sampling/Injection Site
1. Swab the silicone seal of the injection site with 70% isopropyl alcohol
prior to use. Allow to dry for 1 minute.
2. Use a male slip luer syringe or a male luer lock syringe. Grasp the
injection site and firmly push and twist the syringe clockwise onto the
injection site until tight. Gently pull the plunger to fill the syringe.
3. To disconnect, twist the syringe counterclockwise until loose. When the
syringe is removed, the injection site is closed; do not cap.
4. Flush the site in accordance with the facility's protocol.
C. Flushing the System
To flush the system, use a 10 ml LUER-LOK syringe and a volume of flushing
medium that is capable of flushing the system from the needle-free injection/
sampling site to the collection bag. Flush the system by performing the
following procedure.
1. Turn the patient line stopcock to the Closed position.
2. Turn the system stopcock to the Drainage Only position.
3. Place the Drip Chamber stopcock in the Drainage Only position.
4. Verify that all slide clamps are in the open position.
5. Swab the silicone seal of the injection site with 70% isopropyl alcohol
prior to use. Allow to dry for 1 minute.
. ALTERNATE DRAINAGE AND ICP
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6. Use a male slip luer syringe or a male luer lock syringe. Grasp the
injection site and firmly push and twist the syringe clockwise onto the
injection site until tight.
7. Inject flushing medium until the patient line is cleared.
8. To disconnect, twist the syringe counterclockwise until loose. When the
syringe is removed, the injection site is closed; a cap is not required.
Transporting a Patient Connected to the EDS 3 Unit
A. Instructions Prior to Transporting
1. Turn Patient Line stopcock to the Closed position and verify that
drainage into Drip Chamber has ceased.
2. Drain Drip Chamber into drainage bag by placing the Drip Chamber
stopcock into the Drainage Only position.
3. When the CSF has drained completely into the collection bag, place the
Drip Chamber stopcock into the Drip Chamber position.
4. Replace the collection bag by referring to the instructions for use
accompanying the collection bag.
5. Transport the patient.
B. Instructions after Transporting
1. Install EDS 3 device on the I.V. pole.
2. Level the EDS 3 device to the floor and the patient.
3. Verify proper Drip Chamber height settings.
4. Resume drainage by placing the Patient Line stopcock and the System
stopcock in the Drainage Only positions.
Replacing the CODMAN EDS 3 CSF External Drainage System
without Ventricular Catheter (catalog no. 82-1731)
Observe sterile technique during replacement of the collection bag and
tubing set.
1. Occlude the ventricular catheter with rubber shod forceps.
2. Disconnect the LUER-LOK between the catheter and drainage line with
a twisting counterclockwise motion. Discard the EDS 3 system.
3. Install the EDS 3 system by performing the procedures described in
Installing the EDS 3 CSF External Drainage System.
Replacing the Collection Bag
Observe sterile technique during replacement of the collection bag. Refer to
the instructions accompanying the replacement collection bag.
Note: An injection and sampling site is located at the bottom of the
collection bag. To allow drainage from the collection bag, remove this site by
cutting below the clamp using sterile technique.
Removing Fluid From the Collection Bag
Use a 21 gauge non-coring needle and syringe to remove fluid from the
removal site at the bottom of the bag. The removal site can withstand up to
3 punctures from a 21 gauge needle.
Determining the Drainage Rate
WARNING: Care should be taken not to raise or lower the Drip Chamber
when calculating the drainage rate.
1. Collect fluid in the Drip Chamber by turning the Drip Chamber stopcock
to the Drip Chamber position (see Figure 12).
2. After a predetermined amount of time has elapsed, measure the fluid
accumulation in the Drip Chamber in milliliters.
3. Calculate the drainage rate by dividing the volume collected by the
time elapsed.
4. Place the Drip Chamber stopcock to the Drainage Only position. This
causes the fluid to drain from the Drip Chamber to the collection bag.
Laser Care and Maintenance
Exposure to water, dust, heat, or sunlight can damage the laser.
Do not drop the laser leveling device or subject it to stress; damage to the
laser can result.
If the laser does not function, unscrew the end cap and check the polarities
of the batteries. Reposition the batteries, if necessary.
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