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Arrow CVC Quick Manual

Central venous catheter
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Central Venous Catheter (CVC) Product
Rx only.
The Arrow CVC is intended to provide short-term (< 30 days) central venous access for treatment of
diseases or conditions requiring central venous access, including, but not limited to the following:
Lack of usable peripheral IV sites
Central venous pressure monitoring
Total parenteral nutrition (TPN)
Infusions of fl uids, medications, or chemotherapy
Frequent blood sampling or receiving blood transfusions/blood products
See additional labeling for product specifi c indications.
None known. See additional labeling for product specifi c contraindications.
General Warnings and Cautions
1. Sterile, Single use: Do not reuse, reprocess or resterilize. Reuse of device creates a potential
risk of serious injury and/or infection which may lead to death.
2. Read all package insert warnings, precautions and instructions prior to use. Failure to do so
may result in severe patient injury or death.
3. Do not place catheter into or allow it to remain in the right atrium or right ventricle. X-ray
exam or other method in compliance with institutional policies and procedures must
show catheter tip located in lower 1/3 of the Superior Vena Cava (SVC), in accordance with
institutional guidelines.
4. Clinicians must be aware of potential entrapment of the guidewire by any implanted device
in circulatory system. It is recommended that if patient has a circulatory system implant,
catheter procedure be done under direct visualization to reduce risk of guidewire entrapment.
5. Do not use excessive force when introducing guidewire or tissue dilator as this can lead to
vessel perforation, bleeding, or component damage.
6. Passage of guidewire into the right heart can cause dysrhythmias, right bundle branch
block, and a perforation of vessel, atrial or ventricular wall.
7. Do not apply excessive force in placing or removing catheter or guidewire. Excessive
force can cause component damage or breakage. If damage is suspected or withdrawal
cannot be easily accomplished, radiographic visualization should be obtained and further
consultation requested.
8. Using catheters not indicated for high pressure injection for such applications can result in
inter-lumen crossover or rupture with potential for injury.
9. 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
fl ow. Secure only at indicated stabilization locations.
10. Air embolism can occur if air is allowed to enter a central venous access device or vein. Do
not leave open needles or uncapped, unclamped catheters in central venous puncture site.
Use only securely tightened Luer-Lock connections with any central venous access device to
guard against inadvertent disconnection.
11. Clinicians should be aware that slide clamps may be inadvertently removed.
12. Clinicians must be aware of complications associated with central venous catheters
including, but not limited to:
cardiac tamponade
catheter embolism
secondary to vessel,
catheter occlusion
atrial, or ventricular
thoracic duct
pleural (i.e.,
and mediastinal
inadvertent arterial
air embolism
1. Do not alter the catheter, guidewire or any other kit/set component during insertion, use or
2. Procedure must be performed by trained personnel well versed in anatomical landmarks, safe
technique and potential complications.
3. Use standard precautions and follow established institutional policies and procedures.
4. Some disinfectants used at catheter insertion site contain solvents which can weaken the
catheter material. Alcohol, acetone, and polyethylene glycol can weaken the structure of
polyurethane materials. These agents may also weaken the adhesive bond between catheter
stabilization device and skin.
Do not use acetone on catheter surface.
Do not use alcohol to soak catheter surface or allow alcohol to dwell in a catheter lumen to
restore catheter patency or as an infection prevention measure.
Do not use polyethylene glycol containing ointments at insertion site.
Take care when infusing drugs with a high concentration of alcohol.
Allow insertion site to dry completely prior to applying dressing.
5. Ensure catheter patency prior to use. Do not use syringes smaller than 10 mL (a fl uid fi lled
1 mL syringe can exceed 300 psi) to reduce risk of intraluminal leakage or catheter rupture.
6. Minimize catheter manipulation throughout procedure to maintain proper catheter tip position.
nerve injury
fi brin sheath formation
exit site infection
vessel erosion
catheter tip malposition
Kits/Sets may not contain all accessory components detailed in these
instructions for use. Become familiar with instructions for individual
component(s) before beginning the procedure.
A Suggested Procedure: Use sterile technique.
Prep Puncture Site:
1. Position patient as appropriate for insertion site.
• Subclavian or Jugular approach: Place patient in slight Trendelenburg position as tolerated to
reduce risk of air embolism and enhance venous fi lling.
• Femoral approach: Place patient in supine position.
2. Prepare clean skin with an appropriate antiseptic agent.
3. Drape puncture site.
4. Administer local anesthetic per institutional policies and procedures.
5. Dispose of needle.
SharpsAway II™ Locking Disposal Cup (where provided):
The SharpsAway II Locking Disposal Cup is used for disposal of needles (15 Ga. - 30 Ga.).
Using one-handed technique, fi rmly push needles into disposal cup holes (refer to Figure 1).
Once placed into disposal cup, needles will be automatically secured in place so that they cannot be reused.
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.
Where provided, a foam SharpsAway® system may be utilized by pushing needles into foam after use.
Caution: Do not re-use needles after they have been placed into the foam SharpsAway
system. Particulate matter may adhere to needle tip.
Prepare Catheter:
6. Flush each lumen with sterile normal saline for injection to establish patency and prime lumen(s).
7. Clamp or attach Luer-Lock connector(s) to extension line(s) to contain saline within lumen(s).
8. Leave distal extension line uncapped for guidewire passage.
Warning: Do not cut catheter to alter length.
Gain Initial Venous Access:
Echogenic Needle (where provided):
An echogenic needle is used to allow access to the vascular system for the introduction of a guidewire to
facilitate catheter placement. The needle tip is enhanced for approximately 1 cm for clinician to identify
exact needle tip location when puncturing the vessel under ultrasound.
Protected Needle/Safety Needle (where provided):
A protected needle/safety needle should be used in accordance with manufacturer's instructions for use.
Arrow® Raulerson Syringe (where provided):
Arrow Raulerson Syringe is used in conjunction with Arrow Advancer for guidewire insertion.
9. Insert introducer needle or catheter/needle with attached syringe or Arrow Raulerson Syringe
(where provided) into vein and aspirate.
Warning: Do not leave open needles or uncapped, unclamped catheters in central venous
puncture site. Air embolus can occur with these practices.
Caution: Do not reinsert needle into introducer catheter (where provided) to reduce risk of
catheter embolus.
Verify Venous Access:
Utilize one of the following techniques to verify venous access because of the potential for inadvertent
arterial placement:
Central Venous Waveform:
• Insert fl uid primed blunt tip pressure transduction probe into rear of plunger and through
valves of Arrow Raulerson Syringe and observe for central venous pressure waveform.
◊ Remove transduction probe if using Arrow Raulerson Syringe.
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 fl ow.
• Disconnect syringe from needle and observe for pulsatile fl ow.
Warning: Pulsatile fl ow is usually an indicator of inadvertent arterial puncture.
Caution: Do not rely on blood aspirate color to indicate venous access.
Figure 1



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  Summary of Contents for Arrow CVC

  • Page 1 Kits/Sets may not contain all accessory components detailed in these instructions for use. Become familiar with instructions for individual The Arrow CVC is intended to provide short-term (< 30 days) central venous access for treatment of component(s) before beginning the procedure.
  • Page 2 “locked” through Luer-Lock connector(s) using standard institutional policies and procedures. • Place tip of Arrow Advancer – with “J” retracted – into the hole in rear of Arrow Raulerson Syringe • Slide clamp(s) are provided on extension lines to occlude fl ow through each lumen during line plunger or introducer needle (refer to Figure 3).
  • Page 3 Шпрыц Arrow Raulerson выкарыстоўваецца сумесна з Arrow Advancer для ўвядзення правадніка. Пераcцярогі: 9. Прымацаваць шпрыц або пры наяўнасці шпрыц Arrow Raulerson да правадніковай іголкі 1. Не змяняць катэтэр, праваднік або якія-небудзь іншыя кампаненты камплекта ці або іголкі з катэтэрам, увесці іголку ў вену і пацягнуць поршань на сябе.
  • Page 4 задняй частцы поршня шпрыца Arrow Raulerson або правадніковай іголкі. (гл. малюнак 3). неабходнасці. 10. Прасунуць праваднік у шпрыц Arrow Raulerson прыблізна на 10 см, пакуль ён не пройдзе Увага! Для захавання неабходнага месцазнаходжання кончыка катэтэра звесці да праз клапан шпрыца або правадніковую іголку.
  • Page 5 Štrcaljka Arrow Raulerson koristi se zajedno s Arrow Advancerom za uvođenje vodilice. • erozija krvne žile • sredoprsja nehotična punkcija 9. Uvedite uvodnu iglu ili sklop katetera i igle s pričvršćenom štrcaljkom ili štrcaljkom Arrow • • pogrešno postavljen zračna embolija arterije Raulerson (gdje postoji) u venu i aspirirajte.
  • Page 6 Arrow Advancer (gdje postoji): 23. Isperite šupljinu/-e kako biste do kraja uklonili krv iz katetera. Arrow Advancer koristi se za ispravljanje vrška vodilice u obliku slova „J“ radi uvođenja vodilice u 24. Spojite sve produžne katetere na odgovarajuće luer-lock vodove. Nekorišteni port/-ovi štrcaljku Arrow Raulerson ili u iglu.
  • Page 7 5. Před použitím zajistěte průchodnost katétru. V zájmu snížení rizika intraluminálního prosakování nebo prasknutí katétru nepoužívejte stříkačky menší než 10 ml (kapalinou CVC Arrow je určen ke krátkodobému (< 30 dní) centrálnímu žilnímu přístupu za účelem léčby naplněná 1ml stříkačka může překročit tlak 2068,4 kPa).
  • Page 8 Svorka katétru i fi xátor musí být zajištěny pro snížení rizika posunutí poškození. katétru (viz obrázek 5). 13. Odstraňte zaváděcí jehlu a stříkačku Arrow Raulerson (nebo katétr) a zároveň držte vodicí drát na 26. Před aplikací krytí podle pokynů výrobce se ujistěte, že místo zavedení je suché. místě.
  • Page 9 5. Kontrollér, at katetret er åbent, inden det tages i brug. Brug ikke sprøjter, der er mindre end Arrow CVK er indiceret til kortvarig (< 30 dage) central veneadgang ved behandling af sygdomme eller 10 ml (en 1 ml sprøjte fyldt med væske kan overstige 2068,4 kPa), for at mindske risikoen tilstande, der nødvendiggør central veneadgang, inklusive, men ikke begrænset til, følgende:...
  • Page 10 Brug tommelfi ngeren, og træk “J”-spidsen tilbage (se fi gur 2). • Sæt spidsen af Arrow Advancer – med “J”-spidsen trukket tilbage – ind i hullet bag i et Arrow Advarsel: Åbn glideklemmen inden infusion igennem lumen for at mindske risikoen for Raulerson sprøjtestempel eller en introducerkanyle (se fi gur 3).
  • Page 11 9. Breng de introducernaald of de katheter/naald met de daaraan bevestigde spuit of de Arrow 2. De procedure moet worden uitgevoerd door opgeleid personeel dat een grondige Raulerson-spuit (indien verstrekt) in de vene in en aspireer.
  • Page 12 • Plaats de tip van de Arrow Advancer – met de ‘J’ naar achteren getrokken – in de opening aan de achterzijde van de stamper van de Arrow Raulerson-spuit of de introducernaald (zie afbeelding 3). • Gebruik de katheterklem en het bevestigingshulpmiddel als secundaire aanhechtingspunten als dat nodig is.
  • Page 13 • Tsentraalveeni lainekuju 3. Rakendage tavapäraseid ettevaatusabinõusid ja järgige raviasutuses kehtestatud • Sisestage rõhuanduri sondi vedelikuga täidetud tömp ots kolvi tagaossa ja läbi süstla Arrow põhimõtteid ja korda. Raulerson klappide ja veenduge tsentraalveeni rõhu lainekujus. 4. Mõned kateetri sisestuskohas kasutatavad desinfektsioonivahendid sisaldavaid kateetri ◊...
  • Page 14 Luer-Lock-ühenduste abil vastavalt standardsetele raviasutuse eeskirjadele. sisestusnõela tagumises otsas (vt joonist 3). • Pikendusvoolikud on varustatud liugsulguritega voolu sulgemiseks igas valendikus vooliku ja 10. Lükake juhtetraat süstlasse Arrow Raulerson ligikaudu 10 cm võrra kuni selle süstla klappidest või Luer-Lock-ühenduse vahetamise ajaks. sisestusnõelasse ulatumiseni.
  • Page 15 • keuhkopussin septikemia • sisäänvientiin. verisuonen eroosio • (ts. ilmarinta) ja tromboosi 9. Työnnä sisäänvientineula tai ruiskuun kiinnitetty katetri/neula tai Arrow Raulerson -ruisku (jos • • välikarsinan vauriot katetrin kärjen tahaton verisuonen toimitettu) verisuoneen ja aspiroi. • virheellinen asento ilmaembolia punktio Varoitus: Avoimia neuloja tai suojaamattomia, puristamattomia katetreja ei saa jättää...
  • Page 16 • Ohjainvaijerin työntäminen Arrow Raulerson -ruiskun läpi voi edellyttää lievää kiertoliikettä. 25. Käytä katetrin stabilointilaitetta, katetrin puristinta ja kiinnitystä, hakasia tai ompeleita (jos 11. Nosta peukalo ja vedä Arrow Advancer -laitetta noin 4–8 cm poispäin Arrow Raulerson -ruiskusta toimitettu). tai sisäänvientineulasta. Laske peukalo Arrow Advancer -välineen päälle. Samalla kun pidät •...
  • Page 17 υπεζωκότα (δηλαδή • Σύριγγα Arrow Raulerson (όπου παρέχεται): αγγειακή διάβρωση • πνευμοθώρακας) και θρόμβωση • Η σύριγγα Arrow Raulerson χρησιμοποιείται σε συνδυασμό με τη συσκευή Arrow Advancer για την εισαγωγή εσφαλμένη του μεσοθωρακίου • οδηγού σύρματος. ακούσια αρτηριακή • τοποθέτηση άκρου...
  • Page 18 • Τοποθετήστε το άκρο της συσκευής Arrow Advancer – με το άκρο σχήματος «J» ανασυρμένο – μέσα στην οπή που βρίσκεται στο πίσω μέρος του εμβόλου της σύριγγας Arrow Raulerson ή της συγκράτησης, συνδετήρες ή ράμματα (όπου παρέχονται). βελόνας εισαγωγής (ανατρέξτε στην εικόνα 3).
  • Page 19 • Ne használjon alkoholt a katéter felületének áztatásához, és ne hagyja, hogy alkohol Az Arrow CVC eszköz használata javallott rövid távú (30 napnál rövidebb) centrális vénás hozzáférés maradjon a katéter lumenében a katéter átjárhatóságának helyreállítása vagy biztosításához betegségek vagy állapotok centrális vénás hozzáférést igénylő kezeléséhez, egyebek fertőzésmegelőzés céljából.
  • Page 20 (lásd a 3. ábrát). 25. Használjon katéterstabilizáló eszközt, katéterszorítót és rögzítőelemet, tűzőkapcsokat vagy 10. Tolja előre a vezetődrótot az Arrow Raulerson fecskendőbe kb. 10  cm-rel, míg át nem halad a varratokat (ha vannak mellékelve).
  • Page 21 Arrow Raulerson sprauta er notuð með Arrow Advancer fyrir ísetningu leiðaravírs. • stungustað blóðeitrun brjósthimnu (þ.e. • • 9. Setjið nálaslíður eða hollegg/nál með áfestri sprautu eða Arrow Raulerson sprautu (ef hún er til segamyndun æðatæringu loftbrjóst) og • staðar) inn í æð og sogið. •...
  • Page 22 Viðvörun: Opnið slönguklemmu áður en kemur að innrennsli gegnum holrými til að minnka 10. Færið leiðaravírinn fram um það bil 10 cm inn í Arrow Raulerson sprautuna þar til hann fer í hættu á skemmdum á framlengingarslöngum vegna of mikils þrýstings.
  • Page 23 „Arrow Raulerson“ švirkštas yra naudojamas kartu su „Arrow Advancer“ įtaisu kreipiamajai vielai įvesti. • • nervų pažaidos padėtis kateterio 9. Į veną įdurkite punkcinę adatą arba kateterio ir adatos rinkinį su prijungtu švirkštu arba „Arrow • • embolizacija hematoma disritmijos Raulerson“...
  • Page 24 (žr. 3 pav.). 25. fi ksuokite kateterio stabilizavimo įtaisu, kateterio spaustuku ir tvirtikliu, kabutėmis arba 10. Įstumkite kreipiamąją vielą į „Arrow Raulerson“ švirkštą maždaug 10  cm, kol ją pravesite pro chirurginiais siūlais (jei yra).
  • Page 25 5. Kontroller kateterets åpning før bruk. Bruk ikke sprøyter mindre enn 10 ml (en 1 ml sprøyte fylt med væske kan overskride 2068,4 kPa), for å redusere risikoen for intralumenal lekkasje Arrow SVK er beregnet for å gi kortvarig (< 30 dager) sentral venøs tilgang for behandling av eller kateterruptur.
  • Page 26 Trekk tilbake “J” med tommelen (se fi gur 2). porter kan «låses» gjennom Luer-Lock-koblinger ifølge standard retningslinjer og prosedyrer på • Plasser spissen på Arrow Advancer – med “J” trukket tilbake – inn i åpningen bak på Arrow institusjonen. Raulerson-sprøytestempelet eller innføringsnålen (se fi gur 3).
  • Page 27 • Aveți grijă la perfuzia de medicamente cu concentrații mari de alcool. CVC Arrow este indicat pentru a oferi acces venos central de scurtă durată (< 30 de zile) în tratamentul • Lăsaţi locul de introducere să se usuce complet înainte de aplicarea pansamentului.
  • Page 28 Arrow Raulerson sau a acului introducător (consultați Figura 3). Fixarea cateterului: 10. Avansaţi fi rul de ghidaj în seringa Arrow Raulerson pe o distanţă de aproximativ 10 cm, până când acesta trece prin supapele seringii sau în acul introducător.
  • Page 29 4. Neka dezinfekciona sredstva koja se koriste na mestu ulaska katetera sadrže rastvarače u zadnju stranu klipa i kroz ventile Arrow Raulersonovog šprica, a zatim proverite da li se vidi koji mogu da naruše materijal katetera. Alkohol, aceton i polietilen-glikol mogu da naruše talasni oblik centralnog venskog pritiska.
  • Page 30 23. Prošpricajte lumene da biste izbacili svu krv iz katetera. Arrow Advancer služi za ispravljanje vrha u obliku „J“ žice vodilje za uvođenje žice vodilje u Arrow 24. Priključite sve produžne linije na odgovarajuće Luer-Lock priključke. Otvore koje ne koristite Raulersonov špric ili iglu.
  • Page 31 • Pred priložením obväzu nechajte miesto zavedenia celkom uschnúť. CŽK Arrow je určený na zabezpečenie krátkodobého (< 30 dní) centrálneho žilového prístupu pri liečbe 5. Pred použitím skontrolujte priechodnosť katétra. Nepoužívajte striekačky menšie než chorôb alebo stavov, ktoré si vyžadujú centrálny žilový prístup, aj vrátane nasledujúcich aplikácií: 10 ml (striekačka s objemom 1 ml naplnená...
  • Page 32 Zavádzač Arrow Advancer (ak je poskytnutý): 24. Všetky predlžovacie hadičky pripojte podľa potreby k príslušným konektorom so zámkom Zavádzač Arrow Advancer sa používa na vyrovnanie konca v tvare písmena J na vodiacom drôte na Luer-Lock. Nepoužívané porty možno „uzamknúť“ konektormi so zámkami Luer-Lock podľa zavedenie vodiaceho drôtu do striekačky Arrow Raulerson alebo do ihly.
  • Page 33 Показання: • Будьте обережні під час інфузії препаратів із високою концентрацією спирту. ЦВК Arrow показаний для надання короткочасного (< 30 днів) центрального венозного доступу • Почекайте, поки місце введення буде повністю сухим, і тоді накладайте пов’язку. для лікування хвороб або патологічних станів, що потребують центрального венозного доступу, 5.
  • Page 34 25. Користуйтеся пристроєм для стабілізації катетера, зажимом катетера та закріплювачем катетера, скобами або швами (за наявності). 11. Підніміть великий палець руки та відтягніть Arrow Advancer приблизно на 4 - 8 см від • Застосовуйте трикутний адаптер з’єднання, що має бокові крильця, в якості головного...
  • Page 36 повторно повторно застосування світла гумового пошкоджено латексу Arrow International, Inc. Subsidiary of Telefl ex Incorporated Telefl ex Medical IDA Business and Technology Park 2400 Bernville Road | Reading, PA 19605 USA Dublin Road, Athlone, 1-800-523-8446 | 1-610-378-0131 Co. Westmeath, Ireland...