MedComp Split-Stream Mode D'emploi page 21

4. Open extension clamps and white secondary clamps.
5. Aspirate to insure that no air will be forced into the patient.
6. Inject heparin into each lumen using quick bolus technique.
Note: Each lumen should be completely filled with heparin to ensure
effectiveness.
7. Close extension clamps and white secondary clamps.
Caution: Clamps should only be open for aspiration, flushing, and
dialysis treatment.
8. Remove syringes.
9. Attach a sterile injection cap onto the female luers of the
extensions.
• In most instances, no further heparin is necessary for 48-72 hours,
provided the lumens have not been aspirated or flushed.
• Clean skin around catheter. Chlorhexidine gluconate solutions are
recommended. Cover the exit site with occlusive dressing and leave
extensions, clamps, and caps exposed for access by staff.
• Wound dressings must be kept clean and dry.
Caution: Patients must not swim, shower, or soak dressing while
bathing.
• If profuse perspiration or accidental wetting compromises adhesion
of dressing, the medical or nursing staff must change the dressing
under sterile conditions.
Caution: Always review hospital or unit protocol, potential
complications and their treatment, warnings, and precautions prior to
undertaking any type of mechanical or chemical intervention in response
to catheter performance problems.
Warning: Only a physician familiar with the appropriate techniques
should attempt the following procedures.
INSUFFICIENT FLOWS:
The following may cause insufficient blood flows:
•
Occluded arterial holes due to clotting or fibrin sheath.
•
Occlusion of the arterial side holes due to contact with vein wall.
Solutions include:
• Chemical intervention utilizing a thrombolytic agent.
MANAGEMENT OF ONE-WAY OBSTRUCTIONS:
One-way obstructions exist when a lumen can be flushed easily but
blood cannot be aspirated. This is usually caused by tip malposition.
One of the following adjustments may resolve the obstruction:
• Reposition catheter.
•
Reposition patient.
•
Have patient cough.
•
Provided there is no resistance, flush the catheter vigorously with
sterile normal saline to try to move the tip away from the vessel wall.
INFECTION:
Caution: Due to the risk of exposure to HIV (Human Immunodeficiency
Virus) or other blood borne pathogens, health care professionals should
always use Universal Blood and Body Fluid Precautions in the care of all
patients.
SITE CARE
CATHETER PERFORMANCE
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