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7.
Choose appropriate sized catheter for size of vessel to be
cannulated.
8.
Catheter tip must be located in central circulation when
administering > 10% glucose solution, total parenteral
nutrition, continuous vesicant therapy, infusates with
pH less than 5 or greater than 9, and infusates with an
osmolality above 600 mOsm/L, or any medication known
to be irritating to vessels proximal to the vena cava.
9.
Do not leave open needles or uncapped, unclamped
catheters in central venous puncture site. Air embolism
can occur with these practices.
10.
Use only securely tightened Luer-Lock connections
with any Venous Access Device (VAD) to guard against
inadvertent disconnect.
11.
Use Luer-Lock connectors to help guard against air
embolism and blood loss.
12.
Pulsatile flow is usually an indicator of inadvertent
arterial puncture.
Cautions:
1.
Do not use if package has been previously opened or
damaged.
2.
Do not alter the catheter, guidewire, or any other kit/set
component during insertion, use, or removal (except as
instructed).
3.
Procedure must be performed by trained personnel well
versed in anatomical landmarks, safe technique, and
potential complications.
4.
Assess patient for heparin sensitivity. Heparin-Induced
Thrombocytopenia (HIT) has been reported with use of
heparin flush solutions.
5.
Do not use topical antibiotic ointment or creams on
insertion sites (except when using dialysis catheters)
because of their potential to promote fungal infections
and antimicrobial resistance.
6.
Temporarily shut off remaining port(s) through which
solutions are being infused before blood sampling.
7.
Do not rely on blood aspirate color to indicate venous
access.
8.
Do not reinsert needle into introducer catheter to reduce
risk of catheter embolism.
9.
Maintain insertion site with regular meticulous redressing
using aseptic technique.
10.
Engage safety and/or locking feature of scalpel (where
provided) when not in use to reduce risk of sharps injury.
11.
Perform hand hygiene:
• before and immediately after all clinical procedures
• before and after donning and removal of gloves
12.
Properly handle and dispose of sharps in sharps container
in accordance with US OSHA or other governmental
standards for blood borne pathogens and/or hospital/
institutional policy.
13.
Hands must remain behind the needle at all times during
use and disposal.
14.
Use universal blood and body-fluid precautions in the
care of all patients due to the risk of exposure to Human
Immunodeficiency Virus (HIV) or other blood borne
pathogens.
Catheter Warnings and Precautions
Warnings:
1.
Only utilize catheters indicated for high pressure injection
applications for such applications. Utilizing catheters not
indicated for high pressure applications can result in
inter-lumen crossover or rupture with potential for injury.
2.
Do not apply excessive force in placing or removing
catheter. Excessive force can cause catheter breakage. If
placement or withdrawal cannot be easily accomplished,
an x-ray should be obtained and further consultation
requested.
3.
Do not secure, staple, and/or suture directly to outside
diameter of catheter body or extension lines to reduce risk
of cutting or damaging the catheter or impeding catheter
flow. Secure only at indicated stabilization locations.
4.
Do not cut catheter to alter catheter length.
5.
Do not attach catheter clamp and fastener (where
provided) until either guidewire or placement wire is
removed.
6.
Do not use scissors to remove dressing to reduce risk of
cutting catheter.
7.
Open catheter clamp prior to infusion through lumen to
reduce risk of damage to extension line from excessive
pressure.
8.
Practitioners should remove slide clamp(s), where
provided, when not in use. Slide clamp(s) may be
inadvertently removed and aspirated by children or
confused adults.
9.
Do not routinely replace central venous catheters solely
for the purpose of reducing incidence of infection.
10.
Do not use guidewire techniques to replace catheters in
patient suspected of having catheter-related infection.
11.
Residual catheter track remains an air entry point until
completely sealed, occlusive dressing should remain in
place for at least 24 - 72 hours dependent upon amount
of time catheter was indwelling.
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