MedComp SPLIT-STREAM Instructions D'utilisation page 7

5. Take apart female adapter by twisting parts (A) and (C) apart. The
compression ring (B) should be found in part (A).
Warning: Do NOT attempt to separate the extension from the adapter.
These parts are bonded together.
6. Slide adapter part (A) over catheter lumen (D). Slide compression
ring (B) over catheter lumen (D). Insert metal cannula of the adapter
part (C) into catheter lumen with a twisting motion, making sure the
tubing is FULLY seated (until no metal is visible).
7. Slide compression ring (B) toward end of catheter lumen/adapter
assembly (C) until seated as shown.
Caution: Compression ring MUST be fully seated.
8. Slide adapter part (A) toward end of catheter lumen/adapter
assembly (C) and twist adapter together firmly. A gentle tug will
assure proper assembly.
Caution: Assembly threads MUST be fully engaged.
TUNNELIZATION & CUFF PLACEMENT:
9. Position catheter over anticipated tunnel path.
10. Note the desired location at which the cuff will be positioned.
11. Administer sufficient local anesthetic to completely anesthetize the
exit and insertion sites and length of tunnel path.
12. Make a small incision at the exit site on the chest wall
approximately 8-10cm below the clavicle. Make a second
incision above and parallel to the first, at the insertion site. Make
the incision at the exit site wide enough to accommodate the cuff,
approximately 1cm.
13. Use blunt dissection to create the subcutaneous tunnel opening.
Attach the tunneler with tunneling sleeve to the distal tip of the
catheter. Do not attempt to push lumen over barb on tunneler.
Slide the catheter tunneling sleeve over the catheter making certain
that the sleeve covers the arterial holes of the catheter. Insert the
tunneler into the exit site and create a short subcutaneous tunnel.
Tunnel in the direction of the catheter insertion site incision. Do
not tunnel through muscle. The tunnel should be made with care in
order to prevent damage to surrounding vessels.
13a. For Femoral Vein Insertion: Create subcutaneous tunnel with the
catheter exit site in the pelvic region.
Warning: Do NOT over-expand subcutaneous tissue during tunneling.
Over-expansion may delay/prevent cuff in-growth.
14. 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 tunneler with a
slight twisting motion to avoid damage to the catheter.
Warning: Do NOT pull tunneler out at an angle. Keep tunneler straight
to prevent damage to catheter tip.
15. 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".
C
B
C B
D
C
B
C
A
-5-
A
A