Bard Hickman Instructions For Use Manual
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Bard Hickman Instructions For Use Manual

Hemodialysis/apheresis long term central venous catheters
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Bard Access Systems, Inc.
Hickman*
Hemodialysis/Apheresis
Long Term Central
Venous Catheters
Instructions For Use

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  • Page 1 Bard Access Systems, Inc. Hickman* Hemodialysis/Apheresis Long Term Central Venous Catheters Instructions For Use...

  • Page 2: Table Of Contents

    Table of Contents Introduction Indications For Use Contraindications, Warnings, Cautions and Precautions Possible Complications Hickman* Hemodialysis/Apheresis Long Term Central Venous Catheter Placement Procedures Section A: Prepping Procedure Section B: Tunneling Procedure Section C: Cutdown Technique Section D: Percutaneous Technique Catheter Removal...

  • Page 3: Introduction

    Bard Access Systems, Inc. Introduction Description: Hickman* Hemodialysis/Apheresis Central Venous Catheters are constructed of specially formulated and processed silicone. The catheters are radiopaque with female luer locking adapters and SureCuff* tissue ingrowth cuff for fixation of the catheters in a subcutaneous tunnel. Each catheter is provided in a double sterile package.
  • Page 4 Dual Lumen Adapter Legs Attached Clamps Protective Clamping Sleeve Catheter SureCu * Tissue Ingrowth Cu...

  • Page 5: Indications For Use

    I.V. fluids, blood products, drugs, and parenteral nutrition solutions, as well as blood withdrawal. The Hickman* dual lumen hemodialysis / apheresis catheter incorporates two large, equal size lumens appropriate for hemodialysis and apheresis procedures.
  • Page 6 Warnings • Intended for Single Patient Use. DO NOT REUSE. These products are single use devices and should never be reimplanted. Reuse carries with it the attendant concern of cross-infection regardless of the cleaning or sterilization method. Resterilization of incompletely cleaned devices may not be effective.
  • Page 7 Bard Access Systems, Inc. Radiologic: • Grade 1 or 2 distortion on chest X-ray. Pinch-off should be evaluated for degree of severity prior to explantation. Patients indicating any degree of catheter distortion at the clavicle/first rib area should be followed diligently. There are...
  • Page 8 affect the performance of the catheter and connectors. 10% acetone/ 70% isopropyl alcohol swabsticks used for dressing changes should not adversely affect the catheter. I. Prior to beginning placement procedure, do the following: • Examine package carefully before opening to confirm its integrity and that the expiration date has not passed.

  • Page 9: Possible Complications

    Bard Access Systems, Inc. III. After placement, observe the following precautions to avoid device damage and/or patient injury: • Do not use the catheter if there is any evidence of mechanical damage or leaking. Damage to the catheter may lead to rupture, fragmentation and possible embolism and surgical removal.

  • Page 10: Hickman* Hemodialysis/Apheresis Long Term Central Venous Catheter Placement Procedures

    Hickman* Hemodialysis /Apheresis Long-Term Central Venous Catheter Placement Procedures Section A: Prepping Procedure Before beginning procedure, read the “Contraindications, Warnings, Cautions and Precautions” and “Possible Complications” sections of this manual. 1. Create sterile field and open tray. 2. Prep venipuncture/cutdown area, tunnel and tunnel exit areas.
  • Page 11 Bard Access Systems, Inc. Single-Lumen Catheters: Create subcutaneous tunnel from venous entrance to skin exit site using tunneler or long forceps. a. Advance the tip of the tunneler from the venous entry site down to the desired catheter exit site.
  • Page 12 Dual-Lumen Catheters: Create subcutaneous tunnel from skin exit site to venous entrance site using tunneler or long forceps. a. Grasp the tunneler at the end with protective cover. b. Insert the rounded tip of the tunneler into a small incision at the desired catheter exit site.

  • Page 13: Section C: Cutdown Technique

    Bard Access Systems, Inc. g. Estimate the catheter length required for tip placement at the junction of the superior vena cava and right atrium by placing the catheter on the chest along the venous path to the right atrium. Section C: Cutdown Technique 1.

  • Page 14: Section D: Percutaneous Technique

    6. Attach injection cap(s) or connect to intravenous fluid source. 7. Suture catheter at exit site. Note: For dual lumen catheters, the attachable suture wing may be used to secure the catheter. A. Using your fingers, squeeze the suture wing together so that it splits open and place the wing around the catheter near the venipuncture site.
  • Page 15 Bard Access Systems, Inc. 3. Aspirate gently as the insertion is made. Warning: If the artery is entered, withdraw the needle and apply manual pressure for several minutes. If the pleural space is entered, withdraw the needle and evaluate patient for possible pneumothorax.
  • Page 16 6. Gently withdraw and remove needle. Caution: If the guidewire must be withdrawn while the needle is inserted, remove both the needle and guidewire as a unit to help prevent the needle from damaging or shearing the guidewire. 7. Refer to section B for catheter measurement and tunneling procedure.
  • Page 17 Bard Access Systems, Inc. 10. Release the locking mechanism and gently withdraw the vessel dilator and “J” guidewire, leaving the sheath in place. 11. Warning: Hold thumb over exposed orifice of sheath to prevent air aspiration. The risk of air aspiration is reduced by performing this part of the procedure with the patient performing the Valsalva maneuver.
  • Page 18 14. Grasp the two handles of the peel-apart sheath and pull outward and upward at the same time. 15. Peel the sheath away from the catheter completely. Make sure the catheter is not dislodged from vessel as sheath is removed. 16.

  • Page 19: Catheter Removal

    Bard Access Systems, Inc. Catheter Removal After tissue grows into the SureCuff* Tissue Ingrowth Cuff (2 to 3 weeks), catheters can be removed from the subcutaneous tunnel using one of several methods. The method used will depend upon physician preference and the amount of tissue/cuff ingrowth that is present.

  • Page 20: References

    Catheter care and maintenance procedures are included in the Hickman*, Leonard* and Broviac* Catheters Nursing Procedure Manual available through Bard Access Systems Customer Service, 1-800-545-0890. For outside the U.S., contact your local sales representative or distributor.

  • Page 21: Patient Information - Catheter Care And Maintenance

    The catheter should be repaired as soon as possible using the designated Hickman* repair kit. Instructions are enclosed in the repair kit package and are also available in the Hickman*, Leonard* and Broviac* Catheters Nursing Procedure Manual.
  • Page 22 4. Carefully remove the old dressing, starting from the top of the dressing and working downward. Remove the tape or dressing carefully to avoid irritating your skin or pulling on the catheter. Caution: Do not use scissors or any sharp-edged instruments as they could damage the catheter.
  • Page 23 Bard Access Systems, Inc. 10. Repeat step 8 using three of the povidone iodine swabsticks to clean the same skin area again as well as the part of the catheter that will be lying on the cleaned skin. 11. Gently clean the outside of the catheter with the inside surface of an alcohol wipe, starting from the exit site to the catheter connector.

  • Page 24: Clamping The Catheter

    (see diagram) 3. Follow the directions of your doctor or nurse regarding when to clamp. Hickman* catheters come with pre-attached clamps and reinforced clamping sleeves. When should you clamp? Your doctor or nurse may instruct you to clamp your catheter whenever it is not being used.

  • Page 25: Flushing The Catheter And "Heparin Lock" Procedure

    Bard Access Systems, Inc. Flushing the Catheter and “Heparin Lock” Procedure Supplies you will need: • Alcohol or povidone iodine wipe. • 10 mL syringe with attached 1 inch (2.5 cm) needle filled with 2.5 mL of heparin, prepared for use •...

  • Page 26: Changing The Injection Cap

    If you have a multi-lumen catheter, use a separate syringe to flush each lumen with sterile heparin solution. Your doctor or nurse will give you additional information for the care of multi-lumen catheters. Changing the Injection Cap Supplies you will need: •...
  • Page 27 Bard Access Systems, Inc. 7. Pick up the new cap only by the top and remove the sterile tip protector. Attach the new cap by firmly screwing it onto the catheter connector. 8. Cut a 5 cm piece of tape and make tabs on each end by folding back 1 cm.
  • Page 28 An issued or revision date for these instructions is included for the user’s information. In the event two years have elapsed between this date and product use, the user should contact Bard Access Systems to see if additional product information is available.

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