Bard Power-Trialysis, Instructions For Use Manual, Page: 6 / 10

9. Holding the guidewire securely in place, remove the introducer needle.
CAUTION: Do not allow the guidewire to inadvertently advance totally into the vessel.
10. The introducer needle tract is widened by creating a small surgical incision at the skin exit site. The incision should be
slightly larger than the wide/flat side of the catheter.
11. Use the Dualator™ Vessel Dilator(s) to dilate the subcutaneous tissues. Dilate 2-3 times with slow gradual movements. The
larger portion of the Dualator™ Dilator device must enter the vein prior to catheter insertion.
12. Flush each lumen of the catheter with saline or heparinized saline filled syringes and clamp the venous (blue) and arterial
(red) lumens.
13. The catheter is passed over the proximal end of the guidewire by inserting the guidewire tip into the tapered end of the
catheter. The distal (purple) lumen clamp must be in the open position to allow the catheter to pass completely over the
guidewire and into the vein. Insert the catheter flat side to the skin.
14. Pinch guidewire and catheter together, advance together in 5 to 10 cm increments (retract wire as needed). Do not twist the
catheter during over-the-guidewire insertion.
15. The depth markings in one cm increments may be used to determine insertion depth.
16. The catheter tip must be in the lower superior vena cava for optimal performance. If placed femorally, the catheter tip should
be placed in the inferior vena cava to minimize recirculation. Catheters greater than 24 cm are intended for femoral vein insertion.
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CAUTION: For jugular and subclavian insertion, the catheter tip should not be located in the right atrium.
WARNING: Verification of the catheter tip location must be confirmed by x-ray.
17. The guidewire is removed, and the distal (purple) lumen clamp is closed. Flush the lumens again with saline or heparinized
saline filled syringes. It is necessary to open the extension clamps during the flush procedure. Close clamps on all lumens
and place end caps over the ends of each Luer-lock connector.
18. The rotatable, pre-attached suture wing is oriented to the skin surface and the catheter is attached using a suture.
19. When placing the catheter, use the removable suture wing to minimize movement at the exit site. 1. Using your fingers,
squeeze the suture wing together so that it splits open and place the wing around the catheter near the venipuncture site.
2. Secure the wing onto the catheter by tying sutures around the wing using the suture grooves. 3. Secure the removable
wing in place by suturing through the holes or by using adhesive wound closures.
WARNING: For optimal product performance and to avoid complications, do not insert any portion of the curve into the vein.
20. A sterile, transparent, semi-permeable, dressing is used to cover the skin exit site.
WARNING: Verification of the catheter tip location must be confirmed by x-ray to ensure proper placement.
21. The catheter is now ready for use. For hemodialysis, hemoperfusion, or apheresis the arterial (red) lumen of the catheter is
connected to the arterial side of the extracorporeal circuit. The venous (blue) lumen of the catheter is connected to the
venous side of the extracorporeal circuit.
CENTRAL VENOUS PRESSURE MONITORING (CVP)
• Prior to conducting central venous pressure monitoring.
• Ensure proper positioning of the catheter tip.
• Flush catheter vigorously with sterile normal saline.
• Ensure the pressure transducer is at the level of the right atrium.
• It is recommended that a continuous infusion of saline (3 mL/hr) is maintained through the catheter while measuring CVP
to improve accuracy of CVP results.
• CVP Monitoring is intended to be performed through the distal (purple) lumen.
• Use your institution’s protocols for central venous pressure monitoring procedures.
WARNING: CVP Monitoring should always be used in conjunction with other patient assessment metrics when evaluating
cardiac function.
WARNING: CVP Monitoring should not be performed during hemodialysis, hemoperfusion, or apheresis.
Care and Maintenance
The care and and maintenance of the catheter requires well-trained, skilled personnel following a detailed protocol. The protocol should
include a directive that the catheter is not to be used for any purpose other than the prescribed therapy.
Accessing Catheter, Cap Changes, Dressing Changes
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• Experienced personnel
• Use aseptic technique
• Proper hand hygiene
• Clean gloves to access catheter and remove dressing and sterile gloves for dressing changes
• Surgical mask (1 for the patient and 1 for the healthcare professional)
• Catheter exit site should be examined for signs of infection and dressings should be changed at each dialysis treatment.
• Catheter Luer-lock connectors with end caps attached should be soaked for 3 to 5 minutes in povidone iodine and then allowed
to dry before separation.
• Carefully remove the dressing and inspect the exit site for inflammation, swelling and tenderness. Notify physician immediately
if signs of infection are present.