MedComp SPLIT-STREAM Instructions D'utilisation page 17

7. Remove syringe.
INSERTION:
8. Insert the introducer needle with attached syringe, or into the
target vein. Aspirate to insure proper placement.
9. Remove the syringe, and place thumb over the end of the needle to
prevent blood loss or air embolism. Draw flexible end of guidewire
back into advancer so that only the end of the guidewire is visible.
Insert advancer's distal end into the needle hub. Advance guidewire
with forward motion into and past the needle hub into the target
vein.
Caution: The length of the wire inserted is determined by the size of
the patient. Monitor patient for signs of 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.
10. Remove needle, leaving guidewire in the target vein. Enlarge
puncture site with scalpel.
11. 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.
12. Thread Vascu-Sheath
guidewire. Once the Vascu-Sheath
remove the guidewire leaving the sheath and dilator in position.
Warning: 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.
Warning: Never leave sheaths in place as indwelling catheters.
Damage to the vein will occur.
13. Install injection cap over dilator openings to prevent blood loss or air
embolism.
14. Remove dilator and injection cap from sheath.
15. Insert catheter tip into and through the sheath until tip is correctly
positioned in the target vein.
16. Remove the tear-away sheath by slowly pulling the sheath out of the
vessel while splitting the sheath by grasping the tabs and pulling
them apart.
Warning: 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.
17. Make any adjustments to catheter position 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.
TUNNELIZATION & CUFF PLACEMENT:
18. Position catheter over anticipated tunnel path.
introducer over the proximal end of the
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Locate lumen in
this area only.
introducer is in target vein,
1