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12275964 IFU_361-19901 1/20/12 7:05 AM Page 6
Note: A smaller incision may provide better security
of the catheter.
Note: Take care to ensure that the tunnel track has
been anesthetized.
12.Attach the fenestrated end of the catheter onto
the tunneler.
Caution: Exercise care when placing the catheter to
prevent it from coming into contact with surfaces
such as drapes or towels. Silicone rubber is highly
electrostatic and attracts airborne particles and
surface contaminates.
Caution: Use rubber-shod instruments when
handling the catheter. Possible cuts or tears can
occur if rubber-shod instruments are not used.
13.Pass the tunneler (A) and catheter (B)
subcutaneously from the second incision up to
and out through the first incision at the guidewire
insertion site. See Diagram (4). Continue to
draw the catheter through the tunnel until the
polyester cuff lies inside the tunnel, about 1 cm
(C) from the second incision. See Diagram (5).
Disconnect the tunneler from the catheter.
Note: If the cuff is advanced further into the tunnel,
it can make later removal of the catheter difficult.
14.Thread the 16 Fr. peel-away introducer sheath
over the guidewire into the pleural cavity.
15.Remove the guidewire and dilator as a unit,
leaving the 16 Fr. peel-away introducer sheath in
place.
Caution: Place a thumb over the end of the sheath
as the dilator is removed to avoid air entering the
pleural cavity. Care must be taken not to bend or
kink the sheath. Damage to the sheath may prevent
passage of the catheter.
16.Insert the fenestrated end of the catheter into the
sheath advancing it until all the fenestrations are
within the pleural cavity. This can be verified
under fluoroscopy as fenestrations are located
along the barium sulfate stripe.
17.Peel away the sheath while ensuring the catheter
remains in place. Adjust the catheter so that it
lies flat in the tunnel without any kinks.
Caution: Do not use forceps on the introducer to
break the handle and/or peel the sheath.
18.Close the incision at the guidewire insertion site.
19.Close the incision site around the catheter and
suture the catheter to the skin taking care not to
restrict the diameter of the catheter. This suture
is intended to remain in place at least until there
is tissue ingrowth around the cuff.
Caution: Exercise care when placing ligatures to
avoid cutting or occluding the catheter.
Drainage Procedure
The drainage procedure can be performed using:
a) PleurX Vacuum Bottle(s)
b) PleurX Lockable Drainage Line with other
vacuum bottle(s) or
c) Wall Suction
RC081191-2
McGaw Park, IL
Proofed by:
Richard Cisneroz
01-03-12
Dimensions checked:
12275964
If using PleurX Vacuum Bottle(s), refer to PleurX
Drainage Kit Instructions for Use to perform the
drainage procedure.
Caution: Re-expansion pulmonary edema may occur
if too much fluid is removed too rapidly. Therefore,
it is recommended to limit the initial drainage to no
more than 1,500 ml. The volume of pleural fluid
removed should be based on the patient's individual
status.
1. Clamp the drainage line completely closed using
the pinch clamp found on the tubing.
See Diagram (6)
Caution: 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.
Caution: 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.
2. If using wall suction, attach the 5-in-1 adapter to
the Luer fitting on the drainage line. If using a
vacuum bottle other than PleurX, attach a 17 G
needle to the Luer fitting on the drainage line.
Caution: 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 H
O.
2
3. Connect the drainage line to the vacuum/suction
source.
4. Hold the drainage line near the lockable access
tip and remove the protective cover by twisting it
and gently pulling. Take care to avoid contaminating
the lockable access tip. See Diagram (7)
Caution: 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.
5. Continue holding the catheter near the valve.
Carefully insert the lockable access tip into the
catheter valve and advance it completely into the
valve. You will feel and hear a click when the
lockable access tip and valve are securely
connected. See Diagram (8)
Caution: Make sure that the valve and the 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.
6. If desired, lock the access tip to the catheter
valve by twisting the access tip until you feel and
hear a second click. See Diagram (9)
Caution: Precautions should be taken to ensure the
drainage line is not tugged or pulled.
7. Release the pinch clamp on the drainage line to
begin drainage. You can reduce the flow rate by
squeezing the clamp partially closed.
See Diagram (10)
3
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