MedComp Symetrex Mode D'emploi page 7

2. Once proper blood aspiration has been established, ensure both
extension lines are unclamped and flush both lumens with heparinized
saline.
3. Attach syringes filled with an anticoagulant solution (per priming volume
labeled on catheter) and instill the solution into the lumens of the
catheter. Clamp each extension tube. Remove the syringes.
4. ALWAYS ENSURE BOTH INJECTION CAPS ARE ATTACHED TO
CATHETER LUERS POST PLACEMENT.
CAUTION:
Take the following steps to avoid air embolism. Ensure that the
luers are closed between uses. Aspirate then irrigate the catheter with saline
prior to each use. Purge air from the catheter and all connecting tubing
whenever tubing connections are changed.
CAUTION:
Clamp only the extension tubes with the in-line clamps provided
with the Symetrex® Long Term Hemodialysis catheter. Do not use forceps and
do not clamp the distal portion of the catheter.
5. Confirm final position of catheter placement with fluoroscopy or x-ray.
Note: For jugular insertion, the distal tip should be placed within the
right atrium confirmed by fluoroscopy for optimal flow (National Kidney
Foundation Dialysis Outcomes Quality Initiative (DOQI) Guideline 2, K/
DOQI Update 2006).
CAUTION:
Failure to verify catheter placement with fluoroscopy may result in
serious trauma or fatal complications.
6. Suture the tunnel exit site and vein insertion site closed if necessary.
Suture the catheter to the skin with the suture wings. To avoid occluding
or cutting the catheter, do not suture through any part of the catheter
tubing.
7. Apply occlusive dressing to catheter exit site and the tunneled insertion
site using standard institutional protocol.
NOTE:
To prevent cuff dislodgment, it is important to immobilize catheter for
7 days. Catheter must be secured/sutured for entire duration of implantation.
HEMODIALYSIS TREATMENT
To avoid systemic heparinization, the anticoagulant solution must be removed
from each lumen prior to treatment. Aspiration should be based on dialysis unit
protocol. Carefully inspect all connections and extracorporeal circuits before
beginning dialysis. Early leak detection is important to prevent blood loss or air
embolism. Conduct frequent visual inspections for earliest detection. Once a
leak is detected, discontinue dialysis treatment and take all necessary remedial
action before reinitiating treatment. Hemodialysis should be performed under
physician's instructions.
To maintain patency between treatments, a lock must be created in each lumen
of the catheter. It is necessary for each lumen to be completely filled in order for
the lock to be effective. Follow standard institutional protocols when creating
the lock.
1. Ensure that the syringes are free of air and the extension clamps are
closed.
2. Remove caps from the extensions and flush catheter with saline to
remove blood.
3. Attach a syringe containing anticoagulant solution (per designated
priming volume as labeled on catheter) to the luer of each extension.
4. Open the extension clamps and aspirate to ensure that no air will be
forced into the patient.
5. Inject lock into each lumen using quick bolus technique, remove syringes
and cap luers.
PRECAUTION: Luers should be capped in between uses. Luers should only be
uncapped for aspiration, flushing, and dialysis treatment.
PRIMING VOLUME
The following chart outlines the priming volumes for the Symetrex® Long Term
Hemodialysis Catheter. Due to the symmetrical nature of the catheter's distal
tip, there is no predesignated "arterial" or "venous" lumens. The appropriate
Lumen Volume (per catheter length) applies to either lumen.
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