MedComp SPLIT CATH III Instructions D'utilisation page 7

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.
13. Thread Vascu-Sheath
Once the Vascu-Sheath
leaving the sheath and dilator in position.
Caution: DO NOT bend the sheath/dilator during insertion as bending will cause
the sheath to prematurely tear. Hold sheath/dilator close to the tip (approximately
3cm from tip) when initially inserting through the skin surface. To progress the
sheath/dilator towards the vein, regrasp the sheath/dilator a few centimeters
(approximately 5cm) above the original grasp location and push down on the
sheath/dilator. Repeat procedure until sheath/dilator is fully inserted.
Note: For alternate sheath method, see Micro Puncture Insertion Method Section.
Caution: Never leave sheath in place as an indwelling catheter. Damage to the vein
will occur.
14. Install end cap over dilator opening to prevent blood loss or air embolism.
Caution: Do not clamp the dual lumen portion of the catheter. Clamp only the
extensions. Do not use serrated forceps; use only the in-line clamps provided.
15. Remove dilator and end cap from sheath.
16. Insert distal tips of catheter into and through the sheath until catheter tips
are correctly positioned in the target vein.
17. Remove the tear-away sheath by slowly pulling it out of the vessel while
simultaneously 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 a few centimeters at a time.
18. Make any adjustments to catheter under fluoroscopy. The distal venous tip
should be positioned at the level of the caval atrial junction or into the right
atrium to ensure optimal blood flow.
Note: Femoral catheter tip placement is recommended at the junction of the iliac
vein and the inferior vena cava.
19. 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.
20. 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.
21. Close the extension clamps, remove the syringes, and place an end cap on
each luer lock connector. Avoid air embolism by keeping extension tubing
clamped at all times, when not in use, and by aspirating then irrigating the
catheter with saline prior to each use. With each change in tubing
connections, purge air from the catheter and all connecting tubing and caps.
22. To maintain patency, a heparin lock must be created in both lumens. Refer
to hospital heparinization guidelines.
Caution: Assure that all air has been aspirated from the catheter and extensions.
Failure to do so may result in air embolism.
23. Once the catheter is locked with heparin, close the clamps and install end
caps onto the extensions' female luers.
24. Confirm proper tip placement with fluoroscopy. The distal venous tip should
be positioned at the level of the caval atrial junction or into the right atrium
to ensure optimal blood flow (as recommended in current NKF DOQI
Guidelines).
Note: Femoral catheter tip placement is recommended at the junction of the iliac
vein and the inferior vena cava.
Caution: Failure to verify catheter placement may result in serious trauma or fatal
complications.
CATHETER SECUREMENT AND WOUND DRESSING:
25. Suture insertion site closed. Suture the catheter to the skin using the suture
wing. Do not suture the catheter tubing.
Caution: Care must be taken when using sharp objects or needles in close
proximity to catheter lumen. Contact from sharp objects may cause catheter failure.
26. Cover the insertion and exit site with an occlusive dressings.
27. Catheter must be secured/sutured for entire duration of implantation.
28. Record catheter length and catheter lot number on patient's chart.
introducer over the proximal end of the guidewire.
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introducer is in the target vein, remove the guidewire
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