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Caution:
Maintain firm grip on guidewire at all times. Keep sufficient
guidewire length exposed at hub for handling purposes. A
non-controlled guidewire can lead to wire embolism.
Warning:
Do not aspirate with guidewire in place or air may enter
syringe.
Caution:
Do not reinfuse blood to reduce risk of blood leakage from
rear (cap) of syringe.
Warning:
Do not withdraw guidewire against needle bevel to reduce
risk of possible severing or damaging of guidewire.
5. Remove introducer needle and Arrow® Raulerson Syringe (or
catheter) while holding SWG in place.
6. Use centimeter markings on SWG to adjust indwelling length
according to desired depth of indwelling catheter placement.
7. Enlarge cutaneous puncture site with cutting edge of scalpel, if
necessary, positioned away from guidewire.
Warning:
Do not cut guidewire to alter length.
Warning:
Do not cut guidewire with scalpel.
• Position cutting edge of scalpel away from guidewire.
• Engage safety and/or locking feature of scalpel (where
provided) once cutaneous puncture site is enlarged, to
reduce risk of cutting the guidewire (refer to Figure 27).
Engage
8. Use tissue dilator to enlarge puncture site as required.
Warning:
Do not leave tissue dilator in place as an indwelling
catheter. Leaving tissue dilator in place puts patient at risk
for possible vessel wall perforation.
Advance Catheter:
1. Thread tip of catheter over SWG. Sufficient SWG length must
remain exposed at hub end of catheter to maintain a firm grip on
SWG.
2. Grasping near skin, advance catheter into vein with slight
twisting motion.
Warning:
Do not attach catheter clamp and fastener (where provided)
until either guidewire or placement wire is removed.
3. Using centimeter marks on catheter as positioning reference
points, advance catheter to final indwelling position.
Figure 27
NOTE: Centimeter marking symbology is referenced from catheter tip.
• numerical: 5, 15, 25, etc.
• bands: each band denotes a 10 cm interval, with one band indicating
10 cm, two bands indicating 20 cm, etc.
• dots: each dot denotes a 1 cm interval
4. Hold catheter at desired depth and remove SWG.
NOTE: Arrow® catheters are designed to pass freely over SWG.
Caution:
If resistance is encountered when attempting to remove
guidewire after catheter placement, guidewire may
be kinked about tip of catheter within vessel (refer to
Figure 28).
Figure 28
• In this circumstance, pulling back on SWG may result in
undue force being applied resulting in SWG breakage.
• If resistance is encountered, withdraw catheter relative to
SWG about 2-3 cm and attempt to remove SWG.
• If resistance is again encountered, remove SWG and catheter
simultaneously.
Warning:
Do not apply undue force on guidewire to reduce risk of
possible breakage.
5. Verify entire SWG is intact upon removal.
Complete Catheter Insertion:
1. Check lumen placement by attaching a syringe to each extension
line and aspirate until free flow of venous blood is observed.
2. Flush lumen(s) to completely clear blood from catheter.
3. Connect all extension line(s) to appropriate Luer-Lock line(s) as
required. Unused port(s) may be "locked" through luer-activated
connector(s) using standard hospital/institutional protocol.
• Slide clamps are provided on extension lines to occlude flow
through each lumen during line and luer-activated connector
changes.
Warning:
Open catheter clamp prior to infusion through lumen to
reduce risk of damage to extension line from excessive
pressure.
4. Secure catheter: Use a catheter clamp, fastener, catheter
stabilization device, staples or suture, where provided.
• Use triangular juncture hub with side wings as primary
suture site.
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