Bard Power-Trialysis, Инструкция по эксплуатации, Страница: 7 / 10

Exit Site Cleaning
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• Use aseptic technique (as outlined above).
• Clean the exit site at each dialysis treatment with chlorhexidine gluconate unless contraindicated. Apply antiseptic per manufacturer’s
recommendations. Allow to air dry completely.
• Cover the exit site with sterile, transparent, semipermeable dressing or per hospital protocol.
Recommended Cleaning Solutions
Catheter Luer-lock
Connectors/End Caps:
• Povidone iodine
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WARNING: Alcohol should not be used to lock, soak or declot poly-
urethane Dialysis Catheters because alcohol is known to degrade
polyurethane catheters over time with repeated and prolonged
exposure.
Hand cleaner solutions are not intended to be used for disinfecting
our dialysis catheter Luer-lock connectors.
Exit Site:
• Chlorhexidine gluconate 2% solution
(preferred)
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• Chlorhexidine gluconate 4% solution
• Dilute aqueous sodium hypochlorite
• 0.55% sodium hypochlorite solution
• Povidone iodine
• Hydrogen peroxide
• Chlorhexidine patches
• Bacitracin zinc ointments in
petrolatum bases
WARNING: Acetone and Polyethylene Glycol (PEG)-containing oint-
ments can cause failure of this device and should not be used with
polyurethane catheters. Chlorhexidine patches or bacitracin zinc
ointments (e.g., Polysporin™ ointment) are the preferred alternative.
POST DIALYSIS
Use aseptic technique (as outlined above).
1. Flush arterial and venous lumens with a minimum of 10 mL of sterile saline.
WARNING: To avoid damage to vessels and viscus, infusion pressures must not exceed 25 psi (172 kPa). The use of a 10 mL or larger
syringe is recommended because smaller syringes generate more pressure than larger syringes.
2. Inject heparin solution into both the arterial and venous lumens of the catheter. The appropriate heparin solution concentration and
flushing frequency should be based on hospital protocol. Heparin solution of 1,000 to 5,000 units/mL has been found to be effective for
maintaining the patency of hemodialysis and apheresis catheters. When injecting heparin solution, inject quickly and clamp extension
while under positive pressure. Heparin solution volume to lock each lumen must be equal to the priming volume of each lumen. Priming
volumes are marked on each lumen. In most instances, no further heparin solution injection is necessary for 48-72 hours, provided the
catheter has not been aspirated or flushed.
3. Maintain patency of distal (purple) lumen per institution protocol for central lines.
4. Clean catheter Luer-lock connectors per hospital protocol. Attach sterile end caps to both the arterial and the venous clamping
extension pieces.
WARNING: To prevent systemic heparinization of the patient, the heparin solution must be aspirated out of both lumens immediately
prior to using the catheter.
POWER INJECTIONS
Catheter testing included 10 power injection cycles.
CATHETER REMOVAL
Evaluate the catheter routinely and promptly remove any nonessential catheter
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per physician’s orders. Catheter removal must be performed
by persons knowledgeable of the risks involved and qualified in the removal protocol. After removing the catheter, apply manual pressure
to the puncture site for 10-15 minutes until no signs of bleeding are present. Then apply sterile, transparent, semipermeable dressing or
dressing per hospital protocol for a minimum of 8 hours. Follow hospital protocol regarding bedrest after catheter removal.
DISPOSAL
After use, this product may be a potential biohazard. Handle and dispose of in accordance with accepted medical practice and all
applicable local, state and federal laws and regulations.
Troubleshooting
PATIENT WITH FEVER
Patient with fever and chills following the procedure may be indicative of catheter-related bacteremia. If bacteremia is present, removal of
the catheter may be indicated.
INSUFFICIENT FLOW
Excessive force must not be used to flush an obstructed lumen. Insufficient blood flow may be caused by an occluded tip resulting from
a clot or by contacting the wall of the vein. If manipulation of the catheter or reversing arterial and venous lines does not help, then the
physician may attempt to dissolve the clot with a thrombolytic agent (e.g., TPA, Cathflo™ Activase™ thrombolytic). Physician discretion
advised.
CATHETER EXCHANGE
Do not routinely replace dialysis catheters to prevent catheter-related infections
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. It may become necessary to exchange the indwelling
catheter due to a persistent rise in pressures or decrease of flow rates which cannot be rectified through troubleshooting. Catheter
exchanges should be performed under strict aseptic conditions in which the physician should wear a cap, mask, sterile gown, sterile gloves,
and use a large sterile drape to cover the patient.