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3. Perform skin wheal using desired needle and local anesthetic.
4. Dispose of needle.
• In kits where provided, the SharpsAway II™ Locking Disposal
Cup is used for disposal of needles (15 Ga. - 30 Ga.).
See SharpsAway II™ Locking Disposal Cup under Accessory Component
Instructions section.
Caution:
Do not attempt to remove needles that have been placed
into SharpsAway II™ Locking Disposal Cup. These needles
are secured in place. Damage may occur to needles if they
are forced out of disposal cup.
Caution:
Do not re-use needles after they have been placed into the
foam SharpsAway® system. Particulate matter may adhere
to needle tip.
Flush Catheter:
1. Flush each lumen with sterile saline solution, to establish patency
and prime lumen(s).
2. Clamp or attach luer-activated connector(s) to extension line(s)
to contain saline within lumen(s).
3. Leave distal extension line uncapped for SWG passage.
Warning:
Do not cut catheter to alter length.
Catheter Insertion Instructions
Gain Initial Venous Access:
Warning:
Do not leave open needles or uncapped, unclamped
catheters in central venous puncture site. Air embolism can
occur with these practices.
1. Insert introducer needle or catheter/needle with attached syringe
or Arrow® Raulerson Syringe (where provided) into vein and
aspirate.
NOTE: If larger introducer needle is used, vessel may be pre-located with
22 Ga. locater needle and syringe.
See Arrow® Raulerson Syringe under Accessory Component Instructions section.
2. Remove locater needle.
Caution:
Do not rely on blood aspirate color to indicate venous access.
Caution:
Do not reinsert needle into introducer catheter to reduce
risk of catheter embolism.
Verify Venous Access:
Utilize one of the following techniques to verify venous access, because of the
potential for inadvertent arterial placement:
1. Central Venous Waveform:
• Insert fluid primed blunt tip pressure transduction probe into
rear of plunger and through valves of the Arrow® Raulerson
Syringe and observe for central venous pressure waveform.
Remove transduction probe if using Arrow® Raulerson
◊
Syringe.
• Observe for central venous pressure waveform obtained
by a calibrated pressure transducer attached directly to the
introducer needle/catheter (refer to Figure 26).
20
0
Figure 26
2. Pulsatile Flow (if hemodynamic monitoring equipment is not
available):
• Use transduction probe to open syringe valving system of
Arrow® Raulerson Syringe and observe for pulsatile flow.
• Disconnect syringe from needle and observe for pulsatile
flow.
Warning:
Pulsatile flow is usually an indicator of inadvertent arterial
puncture.
Guidewire / SWG Insertion:
1. Straighten "J" of SWG by using a straightening tube or
Arrow Advancer™ (where provided).
See Arrow Advancer™ under Accessory Component Instructions section.
2. Insert tip of SWG into plunger of Arrow® Raulerson Syringe or
into introducer needle.
3. Advance SWG through Arrow® Raulerson Syringe or introducer
needle into vein to desired depth.
• Advancement of "J" Tip through Arrow® Raulerson Syringe
may require a gentle rotating motion.
• Advance SWG until triple band mark reaches rear of Arrow®
Raulerson Syringe plunger.
4. Use centimeter markings on SWG as a reference to assist in
determining how much guidewire has been inserted.
NOTE: If guidewire has three sets of markings, they will be located as follows:
• One band - 10 cm from "J" Tip
• Two bands - 20 cm from "J" Tip
• Three bands - 32 cm from "J" Tip
NOTE: When guidewire is used in conjunction with the Arrow® Raulerson Syringe
(fully aspirated) and a 2-1/2 inch introducer needle, the following positioning
references can be made:
• 20 cm mark entering back of plunger = guidewire tip is at end of needle
• 32 cm mark entering back of plunger = guidewire tip is approximately
10 cm beyond end of needle
CVC | 11
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