MedComp Symetrex Mode D'emploi page 5

• Mediastinal Widening
• Perforation of the Vessel or Viscus
• Pleural injury
• Pneumothorax
• Pulmonary Embolism
• Recurrent Laryngeal Nerve Palsy
• Retroperitoneal Bleed
• Subcutaneous Hematoma
• Thoracic Duct Laceration
• Trauma to Right Atrium
• Tunnel Infection
• Vascular Thrombosis
INSERTION SITES
The ideal site for inserting the Symetrex® Long Term Hemodialysis Catheter is
in the right internal jugular vein. Although this catheter may be placed in the
subclavian vein it is not preferred (National Kidney Foundation Dialysis
Outcomes Quality Initiative (DOQI) Guideline 2, K/DOQI Update 2006).
Catheter also can be placed in the Femoral Vein as required.
STERILIZED BY ETHYLENE OXIDE: Contents sterile and non-pyrogenic
in unopened, undamaged package. Do not use catheter if package has
been damaged or has been opened.
CAUTION
• Patients requiring ventilator support are at increased risk of
pneumothorax during subclavian vein cannulation, which may cause
complications.
• Long time use of the subclavian vein may be associated with subclavian
vein stenosis.
DIRECTIONS FOR CATHETER INSERTION
Part A: Percutaneous Access (Common Steps)
Only a qualified, licensed physician or other qualified health care professional
under the direction of a physician should insert, manipulate, and remove this
catheter. The medical procedures, technique, and methods outlined in these
Instructions For Use are not meant to be a replacement for the
physician's experience and judgment in treating any particular patient
nor do they represent the only
K-DOQI Guidelines recommend the use of fluoroscopic visualization for
placement.
CAUTION:
Insert, maintain and remove catheter under strict Aseptic
conditions and technique. Use standard hospital protocols when applicable.
NOTE:
To reduce the number of cannulation attempts and mechanical
complications, CDC Guidelines recommend the use of Ultrasound Guidance,
if available. Ultrasound guidance should only be used by those fully trained
in its technique.
1. Select the appropriate catheter length to achieve proper tip positioning.
Proper catheter length selection is important and will be determined by
patient anatomy.
2. Administer sufficient local anesthesia to the insertion area and tunnel site
before attempting insertion.
3. Gain percutaneous access to selected vein by inserting introducer needle
attached to syringe. When vein has been entered, remove the syringe,
leaving the needle in place and place thumb over the hub of the needle to
minimize blood loss and the risk of air aspiration.
4. Insert the distal end of guidewire into the needle hub and pass it into
the vasculature. Guidewire should be inserted under Fluoroscopy, when
desired position is reached, the depth markings should be noted.
CAUTION:
The length of the guidewire inserted is determined by the size of
the patient. The guidewire should be held securely during this procedure.
Allowing the guidewire to pass into the right atrium or ventricle may result
in cardiac arrhythmias. Patient should be placed on a cardiac monitor and
monitored for arrhythmia throughout this procedure.
5. Remove needle, leaving guidewire in place.
6. Flush the tissue dilator with sterile, normal or heparinized saline
solution and thread over the guidewire into the vein.
7. Prepare the peel-away introducer, flush peel-away introducer with sterile,
normal or heparinized saline.
8. Remove the tissue dilator leaving the guidewire in vessel.
9. Advance the peel-away introducer over the guidewire and into the vein.
medically acceptable protocols available.
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