• Laceration of Vessels or Viscus precipitation could occur. Warning: Patients requiring ventilator support are Caution: When introducer needle is used, do not assure the security of all caps and bloodline • Lumen Thrombosis at an increased risk of pneumothorax during withdraw guidewire against needle bevel to avoid connections prior to and between treatments. • Mediastinal Injury possible severing of guidewire. • Perforation of the Vessel • Do not infuse against a closed clamp or forcibly subclavian vein cannulation, which may cause complications. 19. Confirm proper tip placement with • Pleural Injury infuse a blocked catheter. 6. Remove the needle, leaving guidewire in the • Pneumothorax fluoroscopy. The distal venous tip should be TRIO-CT™ TRIPLE LUMEN CATHETER • Retroperitoneal Bleed Warning: Extended use of the subclavian vein may vessel. Enlarge cutaneous puncture site with located just before the junction of the superior • Right Atrial Puncture • To avoid damage to vessels and viscus, be associated with subclavian vein stenosis. scalpel to facilitate passage of the dilator and vena cava and the right atrium. HEMODIALYSIS, APHERESIS, AND • Risks Normally Associated with Local or General prolonged infusion pressures must not exceed catheter. INFUSION Anesthesia, Surgery, and Post-Operative Recovery 25 psi (172 kPa). • Confirm final position of catheter with chest Caution: Failure to verify catheter placement • Septicemia x-ray. Routine x-ray should always follow the 7. Thread the dilator over the proximal end of may result in serious trauma or fatal complications. • Spontaneous Catheter Tip Malposition or Retraction INSTRUCTIONS FOR USE • Subclavian only. Pinch-off Prevention: initial insertion of this catheter to confirm the guidewire. Dilate subcutaneous tissue and • Subclavian Artery Puncture CATHETER SECUREMENT AND WOUND Percutaneous insertion of the catheter must be proper tip placement prior to use. vein wall to allow easy passage of catheter into • Subcutaneous Hematoma target vein. DRESSING: INDICATIONS FOR USE: • Superior Vena Cava Puncture made into the axillary-subclavian vein at the junction of the outer and mid-third of the • Thoracic Duct Laceration DIRECTIONS FOR SELDINGER INSERTION 20. Suture the catheter to the skin using the • Vascular Thrombosis clavicle lateral to the thoracic outlet. The Caution: Insufficient tissue dilation can • The Trio-CT™ Triple Lumen Catheter is suture wing. Removable suture wing may be indicated for use in attaining short-term catheter must not be inserted into the cause compression of the catheter lumen • Read instructions carefully before using this used to minimize movement at exit site. Do (less than 30 days) vascular access for • Before attempting the insertion, ensure that subclavian vein medially, because such against the guidewire causing difficulty in the device. The catheter should be inserted, not suture the catheter tubing. hemodialysis and apheresis. The third internal you are familiar with the potential placement can lead to compression of the insertion and removal of the guidewire from manipulated, and removed by a qualified, lumen is intended for infusion, power injection complications and their emergency treatment catheter between the first rib and clavicle the catheter. This can lead to bending of the licensed physician or other qualified health Caution: Care must be taken when using sharp of contrast media and central venous pressure should any of them occur. and can lead to damage or fracture and guidewire. care professional under the direction of a objects or needles in close proximity to catheter monitoring. embolization of the catheter. Fluoroscopic or physician. The medical techniques and lumen. Contact from sharp objects may cause WARNINGS: radiographic confirmation of catheter tip 8. Remove the dilator leaving the guidewire in procedures described in these instructions catheter failure. • The catheter is intended to be inserted in the placement can be helpful in demonstrating place. for use do not represent all medically jugular, femoral or subclavian vein as required. • In the rare event that a hub or connector that the catheter is not being pinched by the acceptable protocols, nor are they intended as Caution: Do not leave vessel dilator in place as an 21. Cover the insertion site with an occlusive The maximum recommended infusion rate is separates from any component during first rib and clavicle.1 indwelling catheter to avoid possible vessel wall dressing leaving extensions, clamps, luers, and 5ml/sec for power injection of contrast media. insertion or use, take all necessary steps a substitute for the physician’s experience and caps exposed for access by the staff. and precautions to prevent blood loss or • Catheters should be implanted carefully to judgment in treating any specific patient. Use perforation. DESCRIPTION: air embolism and remove the catheter. avoid any sharp or acute angles which could standard hospital protocols when applicable. 9. Irrigate catheter with saline, then clamp 22. Catheter must be secured/sutured for entire compromise the opening of the catheter catheter extensions to assure that saline is • The Trio-CT™ Triple Lumen Catheter is a • Do not advance the guidewire or catheter if 1. Strict aseptic technique must be used during duration of implantation. lumens. not inadvertently drained from catheter. Use short-term (less than 30 days) dialysis catheter unusual resistance is encountered. insertion, maintenance, and catheter removal procedures. Provide a sterile operative field. clamps provided. 23. Record catheter length and catheter lot number made of thermosensitive polyurethane. The • Recirculation in fermoral catheters was • Do not insert or withdraw the guidewire The Operating Room is the preferred location on patient’s chart. catheter has three separate lumens allowing reportedly significantly greater than in internal Caution: Do not clamp the lumen portion of the forcibly from any component. The wire may 5 for catheter placement. Use sterile drapes, continuous blood flow. The venous (blue) and jugular catheters. catheter. Clamp only the extensions. Do not use break or unravel. If the guidewire becomes instruments, and accessories. Shave the skin HEMODIALYSIS TREATMENT arterial (red) lumens may be used for serrated forceps, use only the in-line clamps hemodialysis and apheresis treatments. The damaged, the catheter and guidewire must be • Cannulation of the left internal jugular vein above and below the insertion site. Perform provided. • middle (purple) lumen is independent from the removed together. was reportedly associated with a higher surgical scrub. Wear gown, cap, gloves, and The anticoagulant locking solution must be mask. Have patient wear mask. removed from the arterial and venous lumens two dialysis lumens, and may be used for incidence of complications compared to 10. Open distal extension clamp. Thread the • Federal law (USA) restricts this device to sale prior to treatment. Aspiration should be based intravenous therapy, power injection of catheter placement in the right internal jugular catheter over proximal end of the guidewire. contrast media, central venous pressure by or on the order of a physician. vein.2 2. The selection of the appropriate catheter length on dialysis unit protocol. monitoring, blood draws and infusion of is at the sole discretion of the physician. To 11. Ease the catheter through the subcutaneous • This catheter is for Single Use Only. achieve proper tip placement, proper catheter • Before dialysis begins, all connections to medications. The attachable suture wing can • Discard Biohazard according to facility tissue and into the target vein. length selection is important. Routine x-ray catheter and extracorporeal circuits should be be used to provide additional catheter protocol. examined carefully. securement and to minimize movement at the • Do not resterilize the catheter or accessories by should always follow the initial insertion Caution: Observe the patient carefully for signs and of this catheter to confirm proper placement symptoms of cardiac arrhythmia caused by passage exit site. any method. INSERTION SITES: • prior to use. of the catheter into the right atrium. If symptoms Frequent visual inspection should be conducted to detect leaks to prevent blood loss or air CONTRAINDICATIONS: • Re-use may lead to infection or illness/injury. Caution: Left sided placement in particular, may appear, pull back the tip of the catheter until they provide unique challenges due to the right angles Tip Placement are eliminated. embolism. • The manufacturer shall not be liable for any formed by the innominate vein and the left • This catheter is intended for short-term (less • If a leak is found, the catheter should be damages caused by re-use or resterilization of brachiocephalic junction with the left SVC.3,4 than 30 days) vascular access only and should 12. Make any adjustments to catheter under clamped immediately. not be used for any purpose other than this catheter or accessories. fluoroscopy. The distal tip should be located indicated in these instructions. • The patient should be in a modified just before the junction of the superior vena Caution: Only clamp catheter with in-line clamps • Contents sterile and non-pyrogenic in Trendelenberg position, with the upper cava and the right atrium. provided. This device is also contraindicated: unopened, undamaged package. STERILIZED chest exposed and the head turned slightly to the side opposite the insertion area. A small 13. Once proper placement is confirmed, remove • When the presence of device related BY ETHYLENE OXIDE • Necessary remedial action must be taken prior STERILE EO rolled towel may be inserted between the guidewire and close slide clamp. infection, bacteremia, or septicemia is known to the continuation of the dialysis treatment. shoulder blades to facilitate the extension of • Do not use catheter or accessories if package is 14. Attach syringes to all extensions and open or suspected. the chest area. opened or damaged. clamps. Blood should aspirate easily from all Caution: Excessive blood loss may lead to patient • When the patient's body size is insufficient to lumens. If the lumens exhibit excessive shock. • Do not use catheter or accessories if any sign of INTERNAL JUGULAR VEIN resistance to blood aspiration, the catheter accomodate the size of the implanted device. • product damage is visible. may need to be rotated or repositioned to Hemodialysis should be performed under 3. Administer sufficient local anesthetic to • When the patient is known or is suspected to • Have patient lift his/her head from the bed to obtain adequate blood flows. physician’s instructions. completely anesthetize the insertion site. be allergic to materials contained in the device. CATHETER PRECAUTIONS: define the sternomastoid muscle. Catheterization will be performed at the apex • Increased recirculation will occur if the 4. Insert the introducer needle with attached 15. Once adequate aspiration has been achieved, • Do not use sharp instruments near the of a triangle formed between the two heads of arterial and venous lines are reversed during a • If the prospective insertion site has been syringe into the target vein. Aspirate to insure all lumens should be irrigated with saline filled extension tubing or catheter lumen. the sternomastoid muscle. The apex should be dialysis treatment. previously irradiated. proper placement. syringes using quick bolus technique. Assure approximately three finger breadths above the that extension clamps are open during • If the prospective placement site has previously • Do not use scissors to remove dressing. clavicle. The carotid artery should be palpated Note: If arterial blood is aspirated, remove the irrigation procedure. INFUSION suffered episodes of venous thrombosis or medial to the point of catheter insertion. needle and apply immediate pressure to the site for vascular surgical procedures. If local tissue • Catheter will be damaged if clamps other than at least 15 minutes. Ensure that arterial bleeding 16. Close the extension clamps, remove the • The anticoagulant locking solution must be factors may prevent proper device stabilization what is provided with this kit are used. SUBCLAVIAN VEIN has stopped and hematomas have not developed syringes, and place an end cap on each luer removed from the infusion lumen prior to and/or access. lock connectors. Avoid air embolism by keeping • Clamping of the tubing repeatedly in the same • Note the position of the subclavian vein, which before attempting to cannulate the vein again. treatment. Aspiration should be based on extension tubing clamped at all times when location may weaken tubing. Avoid clamping is posterior to the clavicle, superior to the first dialysis unit protocol. POTENTIAL COMPLICATIONS: not in use and by aspirating then irrigating near the luers and hub of the catheter. rib, and anterior to the subclavian artery. (At 5. Remove the syringe, and place thumb over the catheter with saline prior to each use. With • Air Embolus a point just lateral to the angle made by the the end of the needle to prevent blood loss or • Before infusion begins all connections should • Bacteremia each change in tubing connections, purge air • Examine catheter lumen and extensions before clavicle and the first rib.) air embolism. Draw flexible end of guidewire be examined carefully. • Bleeding and after each treatment for damage. back into advancer so that only the end of the from the catheter and all connecting tubing • Brachial Plexus Injury guidewire is visible. Insert advancer’s distal and caps. • Cardiac Arrhythmia FEMORAL VEIN • Frequent visual inspection should be • To prevent accidents, assure the security of all end into the needle hub. Advance guidewire • Cardiac Tamponade 17. To maintain patency, an anticoagulant lock conducted to detect leaks to prevent blood loss caps and bloodline connections prior to and • The patient should lie completely on their with forward motion into and past the needle • Catheter Erosion through the Skin must be created in all lumens. Refer to hospital or air embolism. • Catheter Embolism between treatments. back. Both femoral veins should be palpated hub into the target vein. locking solution protocols guidelines. • Catheter Occlusion for site selection and consequence assessment. • If a leak is found, the catheter should be • Catheter Related Sepsis • Use only Luer Lock (threaded) Connectors The knee on the same side of the insertion site Caution: The length of the wire inserted is clamped immediately. • Central Venous Thrombosis Caution: Assure that all air has been aspirated with this catheter in order to avoid inadvertent should be flexed and the thigh abducted. Place determined by the size of the patient. Monitor • Embolism from the catheter and extensions.Failure to do so disconnection. Only clamp catheter with in-line clamps • Endocarditis foot across the opposite leg. The femoral vein is patient for arrhythmia throughout this procedure. may result in air embolism. Caution: then posterior / medial to the artery. The patient should be placed on a cardiac monitor provided. • Exit Site Infection • Repeated over tightening of bloodlines, • Exsanguination during this procedure. Cardiac arrhythmias may 18. Once the catheter is locked with • Hematoma syringes, and caps will reduce connector life • Note: For femoral placement, monitor patient result if guidewire is allowed to pass into the right anticoagulant locking solution, close the • Necessary remedial action must be taken prior • Hemorrhage and could lead to potential connector failure. closely for thrombosis, infection, and bleeding. atrium. The guidewire should be held securely to the continuation of the infusion treatment. • Hemothorax clamps and install end caps onto the Femoral vein insertions should be left in place during this procedure. • Intolerance Reaction to Implanted Device • Do not infuse incompatible drugs extensions’ female luers. To prevent accidents, for longer than three days. • Laceration of the Vessel simultaneously through the same lumen; Note: Excessive blood loss may lead to patient Warning: Exceeding the maximum indicated flow Caution: Extension clamps should only be open for • Reposition catheter. FLOW RATE TESTING REPRESENTS WARRANTY aspiration, flushing, and dialysis treatment. If clamp shock. rate of 5cc/sec may result in catheter failure and/or OPTIMUM LABORATORY CONDITIONS ® catheter tip displacement. is opened, blood may enter the distal portion of the • Reposition patient. Medcomp WARRANTS THAT THIS PRODUCT 1 Represents maximum indicated flow rate for power injection WAS MANUFACTURED ACCORDING TO APPLICABLE • Infusion treatment should be performed under catheter, ultimately resulting in a thrombus. • Have patient cough. of contrast media. STANDARDS AND SPECIFICATIONS. PATIENT CONDIION, physician’s instructions. Warning: Power injection machine or pressure CLINICAL TREATMENT, AND PRODUCT MAINTENANCE 8. Remove syringes. limiting feature may not prevent over-pressurization 2 MAY AFFECT THE PERFORMANCE OF THIS PRODUCT. • Provided there is no resistance, flush the Internal catheter pressure during power injection with of an occluded catheter, which may result in injector safety cut-off at 300 psi and using contrast media USE OF THIS PRODUCT SHOULD BE IN ACCORDANCE IMPORTANT INFORMATION PERTAINING 9. Attach a sterile end cap onto the female luers catheter vigorously with sterile normal saline catheter failure. with 11.8 cP viscosity. WITH THE INSTRUCTIONS PROVIDED AND AS TO POWER INJECTION: of the extensions. to try to move the tip away from the vessel wall. DIRECTED BY THE PRESCRIBING PHYSICIAN. 3 Max burst pressure is the static burst pressure failure point • Contrast media should be warmed to body 7. Disconnect the power injection device. Because of continuing product improvement, prices, • In most instances, no further anticoagulant • Never forcibly flush an obstructed lumen. If of the catheter. When catheter was occluded failure occurred temperature (37°C) prior to power injection. locking solution is necessary for 48-72 hours, at these pressures. specifications, and model availability are subject to any lumen develops a thrombus, first attempt 8. Flush the catheter with 10cc of sterile normal provided the lumens have not been aspirated change without notice. Medcomp® reserves the right • Warning: Failure to warm contrast to body to aspirate the clot with a syringe. If aspiration to modify its products or contents in accordance saline, using a 10cc or larger syringe. or flushed. Flow vs. Pressure temperature prior to power injection may result fails, the physician may consider using with all relevant regulatory requirements. appropriate agents or thrombolytic agents to in catheter failure. 9. Lock the lumen marked “power injectable” per ® SITE CARE dissolve the clot. Medcomp is a registered trademark of Medical Components, institutional protocol for central lines. 13.5F Trio-CT Triple Lumen Catheter Inc. • Vigorously flush the catheter using a 10cc or Average Pressure - mmHg larger syringe and sterile normal saline prior to 10. Replace the end/needleless cap on the • Clean skin around catheter. Cover the exit site INFECTION: Trio-CT™ is a trademark of Medical Components, Inc. Flow Rate (ml/min) 200 300 400 and immediately following the completion of catheter. with occlusive dressing and leave extensions, Caution: Due to the risk of exposure to HIV Straight Catheters power injection studies. This will ensure the clamps, and caps exposed for access by staff. (Human Immunodeficiency Virus) or other blood 12cm Venous 20 30 51 SYMBOL TABLE patency of the catheter and prevent damage to CENTRAL VENOUS PRESSURE MONITORING (CVP) 5.1.1 borne pathogens, health care professionals should Manufacturer * the catheter. Resistance to flushing may • Alcohol or alcohol-containing antiseptics (such Arterial -21 -40 -60 always use Universal Blood and Body Fluid 5.3.4 indicate partial or complete catheter occlusion. • CVP Monitoring is intended to be preformed as chlorhexidine gluconate) may be used to Keep Dry * Do Not proceed with the power injection study Precautions in the care of all patients. 15cm Venous 20 40 63 through the distal purple lumen. clean the catheter/skin site. 5.4.2 until occlusion has been cleared. Do Not Re-use * Alternate compatible solutions/ointments include: • Sterile technique should always be strictly Arterial -26 -46 -70 5.6.3 • Use your institution’s protocols for central Non-pyrogenic * • Warning: Failure to ensure patency of the adhered to. venous pressure monitoring procedures. 20cm Venous 21 40 62 5.3.2 catheter prior to power injection studies may result • Bactroban Ointment, 2.% Mupirocin, Keep Away from Sunlight * in catheter failure. • Prior to conducting central venous pressure Polyethylene Glycol Ointment, N.F. • Clinically recognized infection at a catheter exit Arterial -30 -50 -70 5.2.3 Sterilized Using Ethylene Oxide * monitoring: • Silvadene Cream, 1% Silver Sulfadiazine. site should be treated promptly with the • Use only the lumen marked “power injectable” appropriate antibiotic therapy. 24cm Venous 30 50 76 5.2.8 Do Not Use if Package is • 10% Povidone-Iodine Ointment Damaged * for power injection of contrast media. 1. Ensure proper positioning of the catheter tip. • Polysporin or Triple Antibiotic Ointment 5.1.4 * Arterial -33 -50 -80 Use-by Date • 0.1% Gentamycin • If a fever occurs in a patient with a catheter in • Do Not exceed the maximum flow rate of 5.2.6 2. Flush catheter vigorously with sterile normal • Hydrogen Perioxide 3% Solution place, take a minimum of two blood cultures 30cm Venous 30 51 84 Do Not Resterilize * 5cc/sec. saline. • 10% Iodophor Iodine from a site distant from catheter exit site. If 5.1.5 Arterial -33 -59 -90 * • Chloroprep, 2% Chlorhexidine blood culture is positive, the catheter must be Batch/Lot Number • Power injector machine pressure 3. Ensure the pressure transducer is at the level 5.1.6 Warning: d-Digluconate + 70% Isopropanol removed immediately and the appropriate Catalogue Number * limiting feature may not prevent over of the right atrium. Note: Flow Rate vs. Pressure data was obtained in (Isopropyl Alcohol) antibiotic therapy initiated. Wait 48 hours 5.4.4 vitro using a blood analog with a viscosity of 3.47 Caution, consult Accompanying pressurization of on occluded catheter. • Anasept, 0.057% Sodium Hydrochlorite before catheter replacement. Insertion should Documents * cP. • It is recommended that a continuous infusion • 70% Alcohol be made on opposite side of original catheter *** • Exceeding the maximum flow rate of Rx Only Prescription Use Only Warning: of saline (3cc/hr) is maintained through the exit site, if possible. 5cc/sec may result in catheter failure and /or 5.3.7 Upper and Lower Temperature catheter while measuring CVP. • Solutions should be allowed to completely dry Limits * catheter tip displacement. **** before applying an occlusive dressing. CATHETER REMOVAL Priming Volume Information: MR Safe Warning: CVP Monitoring should always be MR 13.5F Trio-CT Triple Lumen Catheter • Warning: The indication of power injection of used in conjunction with other patient assessment • Wound dressings must be kept clean and dry. Warning: Only a physician familiar with the * This symbol is in accordance with ISO 15223-1. contrast media implies the catheter’s ability to metrics when evaluating cardiac function. Part Description Priming Volume withstand the procedure, but does not imply the appropriate techniques should attempt the following *** FDA guidance Use of Symbols in Labeling. Straight Catheters Center Arterial Venous appropriateness of the procedure for a particular Warning: CVP Monitoring should not be performed Caution: Patients must not swim, shower, or soak procedures. Note: Temperature symbols : "This symbol only applies to kits with drugs". patient. A suitably trained clinician is responsible during hemodialysis or apheresis. dressing while bathing. 13.5F X 12CM TRIO-CT 0.4 1.2 1.2 for evaluating the health status of a patient as it Caution: Always review hospital or unit protocol, 13.5F X 15CM TRIO-CT 0.4 1.3 1.3 ****This Symbol is in accordance with ASTM F 2503-13 • If profuse perspiration or accidental wetting potential complications and their treatment, pertains to a power injection procedure. CATHETER LOCK 13.5F X 20CM TRIO-CT 0.5 1.5 1.5 compromises adhesion of dressing, the warnings, and precautions prior to catheter removal. • Warning: If local pain, swelling, or signs of medical or nursing staff must change the 13.5F X 24CM TRIO-CT 0.5 1.6 1.6 • If the catheter is not to be used immediately for extravasation are noted, the injection procedure dressing under sterile conditions. Note: The patient should be in a modified 13.5F X 30CM TRIO-CT 0.6 1.9 1.9 treatment, follow the suggested catheter Trendelenberg position. should be stopped immediately. patency guidelines. CATHETER PERFORMANCE Recirculation 1. Cut sutures from suture wing. Follow hospital POWER INJECTION PROCEDURE • To maintain patency between treatments, a protocol for removal of skin sutures. Caution: Always review hospital or unit protocol, Average recirculation rates of 2% for normal flow, catheter lock must be created in each lumen of 1. Remove the end/needleless cap from the potential complications and their treatment, and when arterial and venous lumens are reversed. the catheter. 2. Withdraw catheter through the exit site. catheter. warnings, and precautions prior to undertaking any type of mechanical or chemical intervention in 3. Apply pressure to exit site for approximately MR • Follow hospital protocol for anticoagulant 2. Using a 10cc or larger syringe aspirate for response to catheter performance problems. 10-15 minutes or until bleeding stops. locking solution concentration. adequate blood return to remove locking REFERENCES: solution and to assure patency. Discard Warning: Saline is not intended to serve as a Warning: Only a physician familiar with the 4. Apply dressing in a manner to promote optimal syringe. catheter lock. appropriate techniques should attempt the following healing. 1. Aitken, D.R. and Minton, J.P.; "The Pinch-Off procedures. Sign: A Warning of Impending Problems with 3. Attach a 10cc or larger syringe filled with Permanent Subclavian Catheters," American 1. Draw anticoagulant locking solution into • Discard biohazard according to facility sterile normal saline and vigorously flush the syringes, corresponding to the amount INSUFFICIENT FLOWS: Journal of Surgery, 1984 Nov; 148: 633-38. catheter with the full 10cc of sterile normal protocol. designated on each extension. Assure that the saline. syringes are free of air. The following may cause insufficient blood flows: 2. Sulek, C.A., Blas, M. L., Lobato, E. B., "A Injector pressure should be set at a maximum of 300 psi Randomized Study of Left Verses Right Internal a.) Warning: Failure to ensure patency • Occluded proximal holes due to clotting or fibrin 2. Remove end caps from the extensions. Average Max Catheter Jugular Vein Cannulation in Adults," J Clin of the catheter prior to power injection Max Indicated Average Max Range of Max sheath. Pressure During Max Anesth, 2000 Mar; 12 (2): 142-5. Power Injection Burst Burst studies may result in catheter failure. Indicated Power Injection 3. Attach a syringe containing anticoagulant Flow-Rate1 Pressure3 Pressures3 • Occlusion of the side holes due to contact with Flow Rate2 4. Detach syringe. locking solution to the female luer of each 3. Mickely, V., "Central Venous Catheters: Many vein wall. 5 ml/sec 84 psi 420 psi 332-446 psi extension. questions: Few answers, "Nephrol Dial 5. Attach the power injection device to the Transplant, 2002, 17: 1368-73. catheter per manufacturer’s recommendations. 4. Open extension clamps. Solutions include: 4. Tan, P.L., Gibson, M., "Central Venous 5. Aspirate to ensure that no air will be forced • Warning: Do not power inject through a catheter Chemical intervention utilizing a thrombolytic Catheters: The Role of Radiology," Clin Rad, into the patient. that exhibits signs of clavicle-first rib compression agent. 2006; 61: 13-22. or pinch-off, as it may result in catheter failure. 6. Inject anticoagulant locking solution into each MANAGEMENT OF ONE-WAY OBSTRUCTIONS: lumen using quick bolus technique. 5. National Kidney Foundation K/DOQI Warning: Always use connector tubing between One-way obstructions exist when a lumen can be GUIDELINES 2000, 2006. power injector syringe and catheter. Do not attempt Note: Each lumen should be completely filled to connect power injector directly to the catheter. flushed easily but blood cannot be aspirated. This is with anticoagulant locking solution to ensure usually caused by tip malposition. Damage may result. effectiveness. One of the following adjustments may resolve the 6. Complete power injection study taking care not 7. Close extension clamps. to exceed the flow rate limits. obstruction: PN 40687US Rev. 6/19 A