Arrow MAC Manual page 3

16. Precaution: Properly dispose of sharps in sharps container
in accordance with state/federal OSHA standards for
blood borne pathogens and/or institutional policy.
A Suggested Procedure:
Use sterile technique.
1. Precaution: Place patient in slight Trendelenburg position
as tolerated to reduce the risk of air embolism. If femoral
approach is used, place patient in supine position.
2. Prep area of anticipated venipuncture.
3. Drape puncture site as required.
4. Perform skin wheal with desired needle (25 Ga. or 22 Ga.
needle). In kits where provided, a SharpsAwayII
Disposal Cup is used for the disposal of needles. Firmly push the
needles into the disposal cup holes (refer to Fig. 2). Once placed
into the disposal cup, the needles will be automatically locked
in place so that they can not be reused. Discard the entire cup
at completion of the procedure.
to remove needles that have been placed into cup. These
needles are permanently locked in place. Damage may occur
to the needle if it is forced out of the disposal cup.
Where provided, a foam SharpsAway
be utilized by pushing needles into foam after use.
Precaution: Do not reuse needles after they have been
placed into the foam cup. Particulate matter may
adhere to needle tip.
5. Insert tip of desired catheter through Tuohy-Borst adapter end
of catheter contamination shield. Advance catheter through
tubing and hub at other end (refer to Fig. 3).
Catheter
contamination shield
Catheter tip
6. Slide entire catheter contamination shield to proximal end of
catheter.
7. If fl ow directed catheter is used, infl ate and defl ate balloon
with syringe to ensure integrity.
balloon catheter manufacturer's recommended volume.
Place catheter and catheter contamination shield on sterile fi eld
awaiting fi nal placement.
8. Insert entire length of dilator through hemostasis valve into
catheter pressing hub of dilator fi rmly into hub of hemostasis valve
assembly. Place assembly on sterile fi eld awaiting fi nal placement.
SZ11142111A0.indb Sec2:2 SZ11142111A0.indb Sec2:2
Locking
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Precaution: Do not attempt
Fig. 2
system may
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Catheter
Tuohy-Borst adapter
Fig. 3
Precaution: Do not exceed
2
9. Insert introducer needle with attached Arrow
Syringe into vein and aspirate. (If larger introducer needle is
used, vessel may be pre-located with 22 Ga. locater needle and
syringe.) Remove locater needle.
Alternate Technique:
Catheter/needle may be used in the standard manner as
alternative to introducer needle. If catheter/needle is used,
Arrow Raulerson Syringe will function as a standard syringe,
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but will not pass spring-wire guide. If no free fl ow of venous
blood is observed after needle is removed, attach syringe
to the catheter and aspirate until good venous blood fl ow is
established. Precaution: The color of the blood aspirated is
not always a reliable indicator of venous access.
reinsert needle into introducer catheter.
10. Because of the potential for inadvertent arterial placement, one
of the following techniques should be utilized to verify venous
access. Insert the fl uid primed blunt tip transduction probe into
the rear of the plunger and through the valves of the Arrow
Raulerson Syringe. Observe for central venous placement via
a wave form obtained by a calibrated pressure transducer.
Remove transduction probe (refer to Fig. 4).
20
0
Fig. 4
Alternate Technique:
If hemodynamic monitoring equipment is not available to permit
transducing a central venous wave form, check for pulsatile fl ow
by either using the transduction probe to open the syringe valving
system or by disconnecting the syringe from the needle. Pulsatile
fl ow is usually an indicator of inadvertent arterial puncture.
Precaution: The color of the blood aspirated is not always a
reliable indicator of venous access. 10
11. Using the two-piece Arrow Advancer ™
through syringe into vein. Warning: Aspiration with spring-
wire guide in place will cause introduction of air into syringe.
Precaution: To minimize the risk of leakage of blood from
syringe cap do not reinfuse blood with spring-wire guide in place.
Two-Piece Arrow Advancer Instructions:
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• Using your thumb, straighten the "J" by retracting the spring-
wire guide into the Arrow Advancer
Fig. 5
Raulerson
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10 Do not
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, advance spring-wire guide
(refer to Figs. 5, 6).
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