Integra Codman CERTAS Plus Mode D'emploi page 24

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4 . Remove valve from the sterile package, and connect the valve
to the manometer/syringe assembly.
5 . Adjust the stopcock to connect the syringe to the valve
assembly (Figure A-2).
6 . Position the valve vertically with the outlet pointed downward.
7 . Using the syringe, gently flush saline through the system
while gently pressing the reservoir to purge air bubbles from
the valve assembly. Once fluid begins flowing through the
valve mechanism, the outlet of the valve can be pointed
upward to further assist in evacuating air from the system.
Note: An excessive flow rate (>0.75 mL/min) activates
SIPHONGUARD and creates the impression that the valve is
distally occluded. In reality, flow is being diverted to the high
resistance secondary pathway.
8 . Attach a distal catheter to the valve and gently flush saline
through the system to ensure that the catheter is purged of
air.
9 . The device is now ready for SIPHONGUARD Test Procedure or
Manometer Testing.
Note: All valves are susceptible to damage due to excessive
flow rate during testing. Take extreme care when flushing
a valve as damage can occur when excessive flow rates are
used. It is recommended to use a flow rate of no greater than
0.5 mL/min.
SIPHONGUARD Test Procedure
Note: This procedure applies only to valves with an integrated
SIPHONGUARD.
Note: Perform this procedure immediately after completing the
flushing procedure. This procedure is designed to provide visual
confirmation of proper functioning of SIPHONGUARD.
1 . Use a full syringe of saline solution attached to the 4-way
stopcock to fill the manometer to the top.
2 . Turn the stopcock to connect the manometer to the valve
and SIPHONGUARD (Figure A-3).
3 . Bring the end of the distal catheter level with the fluid level in
the manometer (Figure A-4).
Note: The device must lie on a sterile surface and remain
undisturbed for the duration of the test.
4 . Hold the distal end of the catheter adjacent to the manometer
and slowly lower the end of the catheter until the fluid level
in the manometer begins to drop.
5 . Continue to lower the end of the catheter at a rate that exceeds
the drop rate of the fluid level in the manometer. As you do so,
you will note a corresponding increase in the rate of descent of
the fluid level in the manometer.
6 . A point will be reached where the rate of descent of the fluid
level in the manometer dramatically decreases, but does NOT
stop. This is the point at which SIPHONGUARD's primary
pathway closes and flow diverts to the higher resistance
secondary pathway. This confirms proper functioning of
SIPHONGUARD.
7 . Repeat Steps 3 through 6 as necessary to reconfirm
SIPHONGUARD function.
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