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Caution: DO NOT grasp and pull the guidewire prior to
releasing the J-Straightener. Damage to the guidewire may
occur if it is pulled against the restraint of the J-Straightener.
11. 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 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.
12. Remove needle, leaving guidewire in the target vein. Enlarge
cutaneous puncture site with scalpel.
13. 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.
Caution: Do not leave vessel dilator(s) in place as an
indwelling catheter to avoid possible vessel wall perforation.
14. Thread Vascu-Sheath
guidewire. Once the Vascu-Sheath
vein, remove the guidewire leaving the sheath and dilator in
position.
Caution: 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 ini-
tially 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.
Note: For alternate sheath method, see Micro Puncture
Insertion Method Section.
Caution: Never leave sheath in place as an indwelling
catheter. Damage to the vein will occur.
15. Install end cap over dilator opening to prevent blood loss or air
embolism.
Caution: Do not clamp the dual lumen portion of the
catheter. Clamp only the extensions. Do not use serrated
forceps; use only the in-line clamps provided.
16. Remove dilator and end cap from sheath.
17. Insert distal tips of catheter into and through the sheath until
catheter tips are correctly positioned in the target vein.
18. Remove the tearaway sheath by slowly pulling it out of the
vessel while simultaneously splitting the sheath by grasping
the tabs and pulling them apart (a slight twisting motion may
be helpful).
introducer over the proximal end of the
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introducer is in the target
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