CareFusion PleurX Pleural Catheter Mini Kit Manual page 5

12275964 IFU_361-19901 1/20/12 7:05 AM Page 5
The pinch clamp must be fully closed to occlude the
drainage line. When not connected to a suction
source, make sure the pinch clamp is fully closed.
Otherwise the drainage line may allow air into the
body or let fluid leak out.
When connecting to a vacuum bottle, make sure the
pinch clamp on the drainage line is fully closed.
Otherwise, it is possible for some or all of the
vacuum in the bottle to be lost.
When draining with glass vacuum bottles, do not
use a needle larger than 17 G If wall suction is used,
it must be regulated to no greater than
(-)60 cm H2O.
Keep the valve on the PleurX Catheter and the
lockable access tip on the drainage line clean. Keep
them away from other objects to help avoid
contamination.
Make sure that the valve and lockable access tip are
securely connected when draining. If they are
accidentally separated, they may become
contaminated. If this occurs, clean the valve with an
alcohol pad and use a new drainage set to avoid
potential contamination.
Precautions should be taken to ensure the drainage
line is not tugged or pulled.
It is normal for the patient to feel some discomfort
or pain when draining fluid. If discomfort or pain is
experienced when draining, clamp the drainage line
to slow or stop the flow of fluid for a few minutes.
Pain may be an indication of infection.
Potential complications of access and drainage of
the pleural cavity include, but may not be limited to,
the following: re-expansion pulmonary edema,
pneumothorax, laceration of lung or liver,
hypotension/circulatory collapse, wound infection,
empyema and infection in the pleural space.
Sterility
This product has been sterilized. It is for single use
only and is not to be resterilized. Do not use if
package is damaged. CareFusion will not be
responsible for any product that is resterilized, nor
accept for credit or exchange, any product that has
been opened but not used.
General Guidelines
1. The procedure for pleural placement can be
performed using local anesthetic and sedation.
However, depending on patient needs, it may be
performed using alternative approaches to
anesthesia or sedation.
2. Use of image guidance may aid in the accuracy
and safety of catheter placement. Care should be
taken to identify and avoid contact with
vasculature near the guidewire insertion site.
3. Guidewire insertion site selection should be
based upon patient anatomy and presentation
with consideration given to any possible
adhesions or loculated pockets of fluid.
4. Consideration should be given to the patient's
ease of access in determining the location of the
catheter exit site.
RC081191-2
McGaw Park, IL
Proofed by:
Richard Cisneroz
01-03-12
Dimensions checked:
12275964
Suggested Placement Procedure
Tunneled
portion of
catheter
External portion
of catheter
(3)
Proper medical and surgical procedures are the
responsibility of the physician. The appropriateness
of any procedure must be based upon the needs of
the patient. Diagram (3) illustrates the placement of
the PleurX Pleural Catheter, as described in the
following procedure.
1. Position the patient appropriately to access the
desired guidewire insertion site.
2. Identify the appropriate intercostal space for
guidewire placement. The guidewire is typically
placed in the sixth or seventh intercostal space.
Ultrasound can be used to confirm the guidewire
insertion site.
3. Identify the location of the catheter exit site,
which is usually approximately 5 cm inferior and
lateral to the guidewire insertion site.
4. Surgically prep the patient.
5. Drape and anesthetize the planned insertion and
tunneling sites.
Caution: Care must be taken when inserting the
needle to avoid puncturing or lacerating the lung or
liver.
6. Insert the 18 G needle, attached to a small
syringe, directly through the desired intercostal
space and just over the lower rib.
7. Ensure free aspiration of pleural fluid, then
remove the syringe, leaving the needle in place.
8. Insert a guidewire through the needle, advancing
it well into the pleural cavity.
9. Remove the needle, leaving the guidewire in
place.
Caution: Damage to the guidewire may result if
withdrawn through the needle.
10.Make a 1 cm incision at the guidewire insertion site.
11.Make a second 1-2 cm incision approximately
5 cm inferior and lateral to the guidewire
insertion site. This incision will be the catheter
exit site. Consider the patient's ease of access in
determining its location. See Diagram (3).
2
Date:
Copy checked:
First Incision:
Guidewire
Insertion Site
Second
Incision:
Catheter
exit site