Hemodialysis Dialysis Catheter Kit

• AdvaCare hemodialysis catheter kits are equipped with a specially designed soft and tapered tip for smooth and easy insertion of the catheter into the patient’s skin, significantly reducing the risk of trauma in the process;
• The clear radio-opaque material of the catheter along with clear definite markings allow for smooth and easy insertion of the catheter into the patient’s skin;
• As a result of strategically placed venous ports, the recirculation rate is reduced greatly (to less than 5%).

Several complications can happen when using the product. Before attempting the insertion of the hemodialysis catheter, the physician should be familiar with the following health complications along with their subsequent emergency treatment should they occur:

• Air Embolus;
• Allergic Reactions;
• Bacteremia;
• Bleeding at the Site;
• Brachial Plexus Injury;
• Cardiac Arrhythmia;
• Cardiac Tamponade;
• Catheter damage due to compression between the clavicle and first rib;
• Catheter Embolism; Catheter Occlusion;
• Catheter or cuff erosion through the skin;
• Central Venous Thrombosis;
• Endocarditis;
• Exit Site Infection;
• Exit Site Necrosis;
• Exsanguination;
• Extravasation;
• Fibrin Sheath Formation;
• Hemothorax;
• Hematoma;
• Hemorrhage;
• Inflammation;
• Necrosis or scarring of skin over the implant area;
• Laceration of the Vessel;
• Lumen Thrombosis;
• Mediastinal Injury;
• Perforation of the Vessel;
• Pleural Injury;
• Pneumothorax;
• Pulmonary Emboli;
• Retroperitoneal Bleed;
• Right Atrial Puncture;
• Risks normally associated with local and general anesthesia, surgery, and post-operative recovery;
• Septicemia;
• Spontaneous Catheter Tip Malposition or Retraction;
• Subclavian Artery Puncture;
• Subcutaneous Hematoma;
• Superior Vena Cava Puncture;
• Thoracic Duct Laceration;
• Thrombocytopenia;
• Thromboembolism;
• Tunnel Infection;
• Ventricular Thrombosis;
• Vessel Erosion;
• Vascular Thrombosis.

There are several insertion sites a physician can use. The right internal jugular vein is the primary anatomical location for long-term hemodialysis catheters. However, the left internal jugular vein, as well as the external jugular veins and subclavian veins can also be a good consideration.

When inserting the device, the patient should be in a modified Trendelenburg position, with the upper chest exposed and the head turned slightly to the side opposite the insertion area. As a second step, have the patient lift his/her head from the bed to expose the sternocleidomastoid muscle.

The catheterization process will be performed at the apex of the triangle formed between the two heads of the sternocleidomastoid muscle above the clavicle.

The carotid artery should be palpated medial to the point of catheter insertion:

• Using ultrasound, ensure the jugular vein is patent and distended;
• Confirm final position of catheter with chest x-ray or fluoroscopy.

A routine x-ray should always follow the initial insertion of this catheter to confirm proper tip placement before use. To optimize self-centering tip design, the contact point of the curved arterial tip should be positioned in the lower third of the vena cava, with the venous tip in the right atrium or at the junction of the right atrium and superior vena cava. Alternatively, both tips of the catheter may be placed in the right atrium under fluoroscopy.

• Do not advance the guidewire or catheter if unusual resistance is encountered;
• Avoid inserting or withdrawing the guidewire forcibly from any component as the wire may break or unravel;
• Use of excessive force on the catheter may cause the suture wing to detach from the bifurcation;
• In the event that a clamp breaks, replace the catheter at the earliest opportunity;
• Meticulously inspect the equipment to make sure it is sterile and non-pyrogenic in an unopened, undamaged package;