8. Measure Distance to Tip Location
1. Using fluoroscopic control, determine the correct catheter length by advancing the
guidewire to the desired catheter tip location in the SVC.
2. Once the guidewire tip is in proper position, mark the length by clamping forceps onto
the guidewire at the skin site.
9. Removing Dilator and Guidewire
1. Rotate locking collar of dilator and remove dilator from sheath.
2. Withdraw the dilator and guidewire, leaving the small sheath in place.
WARNING: Place a finger over the sheath opening to minimize blood loss and risk of air
aspiration. The risk of air embolism is reduced by performing this part of the procedure with
the patient performing the Valsalva maneuver or by attaching a syringe or injection cap to the
dilator to reduce blood flow while trimming the catheter.
10. Modification of Catheter Length
Note:
Catheters can be cut to length if a different length is desired due to patient size
and desired point of insertion according to hospital protocol. Catheter depth markings
are in centimeters.
1. Measure the distance from the insertion site (zero mark) to the desired tip location.
2. Using the guidewire to indicate desired length, retract the stylet behind the point the
catheter is to be cut.
3. Using a sterile scalpel or scissors, carefully cut the catheter according to institutional
policy if necessary.
4.
Caution:
When trimming the catheter, do not cut stylet.
5. Inspect cut surface to assure there is no loose material.
6. Re-advance the stylet to the distal end of the trimmed catheter.
11. Insert and Advance the Catheter
1. Insert the catheter and stylet as a unit into the microintroducer sheath.
2. Advance the catheter slowly.
12. Retract and Remove Microintroducer Sheath
1. Stabilize the catheter position by applying pressure to the vein distal to the
microintroducer sheath.
2. Withdraw the microintroducer sheath from the vein and away from the site.
3. Split the microintroducer sheath and peel it away from the catheter.
13. Complete Catheter Insertion
1. Continue to advance the catheter. For central placement, when the tip has advanced to the
shoulder, have the patient turn head (chin on shoulder) toward the insertion side to prevent
possible cannulation into the jugular vein.
Caution:
The
PowerPICC* SV
catheter features a reverse-taper catheter design.
Placement of larger catheters at or below antecubital fossa may result in an increased
incidence of phlebitis. Placement of the
PowerPICC* SV
catheter above antecubital fossa is
recommended.
2. Position the arm at a 90° angle, maintaining sterility. Complete catheter advancement into
the desired position (zero mark).
WARNING: This is not a right atrium catheter. Avoid positioning the catheter tip in the right
atrium. Placement or migration of the catheter tip into the right atrium may cause cardiac
arrhythmia, myocardial erosion or cardiac tamponade. The risk of these complications may
be more likely in neonatal patients.
3. Stabilize the catheter position by applying light pressure to the vein distal to the insertion site. Slowly remove the stylet.
4. Place a finger over the catheter opening to minimize blood loss.
0
0
Zero mark
