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SENSATION® 7Fr. IAB CATHETER INSTRUCTIONS FOR USE

SENSATION® 7Fr. IAB CATHETER INSTRUCTIONS FOR USE

SENSATION® 7Fr. IAB CATHETER INSTRUCTIONS FOR USE

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| 4 | SENSATION <strong>7Fr</strong>. | Instructions for Use |<br />

Figure 15<br />

Figure 16<br />

Figure 17<br />

19. Manually flush inner lumen with 3-5cc flush solution.<br />

STYLET CAP<br />

PRECAUTION<br />

STYLET WIRE<br />

FEMALE LUER HUB<br />

DO NOT handle the <strong>IAB</strong> Membrane or wipe the catheter prior to<br />

insertion.<br />

20. Withdraw the balloon membrane from the protective T-handle by<br />

PULLING THE <strong>CATHETER</strong> STRAIGHT OUT OF THE T-HANDLE.<br />

(See Figure 16)<br />

PRECAUTION<br />

Remove the <strong>IAB</strong> catheter from the T-handle by pulling STRAIGHT OUT<br />

to avoid damaging it.<br />

21. Insert the 0.018" (0.05 cm) guide wire through the inner lumen.<br />

(See Figure 17) Advance the <strong>IAB</strong> catheter over the guide wire<br />

until the guide wire exits the female luer hub. Always ensure the<br />

Operator has complete control of the guide wire.<br />

<strong>IAB</strong> <strong>CATHETER</strong> TIP<br />

WARNING<br />

SKIN LINE<br />

0.018" (0.05 cm)<br />

GUIDE WIRE<br />

Do not use excessive force when inserting the <strong>IAB</strong> catheter. If you<br />

use excessive force when inserting the <strong>IAB</strong> catheter, arterial tearing,<br />

dissection, or balloon membrane damage may occur.<br />

NOTE: During insertion of the <strong>IAB</strong> catheter, arterial blood under pressure<br />

may run down the length of the folds in the balloon membrane and drip or<br />

be expelled under arterial pressure from the balloon membrane/catheter<br />

junction. THIS “CHANNELING” IS NOT A LEAK. As the <strong>IAB</strong> catheter is advanced<br />

the bleeding will diminish.<br />

22. While controlling the proximal end of the guide wire, advance the<br />

<strong>IAB</strong> catheter over the guide wire into the artery. Always grasp the <strong>IAB</strong><br />

catheter no more than one inch (2.5 cm) from the insertion site or<br />

sheath hub and advance in short continuous strokes to avoid kinking the<br />

<strong>IAB</strong> catheter while maintaining complete control of the guide wire.<br />

PRECAUTIONS<br />

DO NOT twist the catheter during insertion.<br />

Always advance in short, continuous, one inch (2.5 cm) strokes to<br />

avoid kinking the <strong>IAB</strong> Catheter.<br />

WARNINGS<br />

Any kinking or damage to the inner lumen may result in subsequent<br />

fatigue failure to the inner lumen when pumping.<br />

Do not insert the <strong>IAB</strong> catheter unless the inner lumen is supported by<br />

a guide wire.<br />

23. Advance the <strong>IAB</strong> catheter to the proper position in the descending<br />

thoracic aorta, with the <strong>IAB</strong> catheter tip just distal (approximately 2<br />

cm) to the left subclavian artery. (See Figure 18)<br />

2 cm<br />

LEFT<br />

SUBCLAVIAN<br />

ARTERY<br />

<strong>IAB</strong> <strong>CATHETER</strong> TIP<br />

AORTIC-ILIAC<br />

BIFURCATION<br />

MAXIMUM<br />

DISTANCE<br />

POSSIBLE<br />

Figure 18<br />

WARNING<br />

If you do not use fluoroscopy during <strong>IAB</strong> catheter insertion, you MUST<br />

take an X-ray as soon as possible to ascertain that the <strong>IAB</strong> catheter is<br />

properly positioned.<br />

PRECAUTION<br />

If using a chest X-ray to identify the location of the <strong>IAB</strong> catheter, it is<br />

recommended to place the <strong>IAB</strong>P in the standby mode while the X-ray<br />

is taken and then immediately resume pumping.<br />

24. Maintain sterility of the exposed catheter until the proper <strong>IAB</strong><br />

catheter position is verified.<br />

<strong>INSTRUCTIONS</strong> <strong>FOR</strong> <strong>USE</strong> OF SHEATH SEAL WITH INTRODUCER SHEATH<br />

PRECAUTION<br />

Do not place any sutures or ligatures around the outside diameter of<br />

the introducer to avoid kinking or damaging the sheath.<br />

Push the Universal Sheath Seal into the hub of the introducer sheath.<br />

(See Figure 19)<br />

Figure 19<br />

HEMOSTASIS<br />

VALVE<br />

STAT GARD<br />

SLEEVE<br />

UNIVERSAL<br />

SHEATH SEAL<br />

If it becomes necessary to reposition the <strong>IAB</strong> catheter, hold the sheath<br />

seal in one hand, grasp the catheter through the STAT-GARD sleeve<br />

with the other hand, and reposition under aseptic conditions. Do not<br />

attempt to reposition the <strong>IAB</strong> catheter by moving the sheath.<br />

NOTE: If blood is seen passing the sheath seal following insertion through a<br />

sheath, disengage sheath seal from hemostasis valve.<br />

WHEN USING INTRODUCER SHEATH<br />

WARNING<br />

If the balloon membrane has not entirely exited the introducer sheath,<br />

it will not inflate and deflate properly.<br />

NOTE: Either during advancing or once the catheter is correctly positioned;<br />

confirm that the <strong>IAB</strong> catheter membrane has fully exited the sheath.<br />

(See Figure 20)<br />

Figure 20<br />

1<br />

FIRST SINGLE MARK<br />

ENTIRE BALLOON<br />

MEMBRANE HAS LEFT<br />

6" (15.2 cm) INTRODUCER<br />

SHEATH<br />

END of BALLOON<br />

MEMBRANE<br />

6" (15.2 cm) INTRODUCER SHEATH<br />

1. The first single band from the <strong>IAB</strong> catheter tip indicates that the<br />

entire balloon membrane has exited from the 6" (15 cm) introducer<br />

sheath/hemostasis valve and may now be inflated.<br />

2. Single bands follow at 3/4" (2 cm) increments.<br />

C. INITIATING <strong>IAB</strong> PUMPING (<strong>IAB</strong>P)<br />

NOTE: Do not raise the head of the bed greater than 45°.<br />

1. After positioning the <strong>IAB</strong> catheter, remove the guide wire.<br />

2. Once the catheter is in place, aspirate and discard 3cc of blood<br />

from the inner lumen and then immediately perform a manual<br />

flush using a syringe filled with 3cc to 5cc of flush solution. This<br />

will minimize the chances of stagnant blood clotting in the inner<br />

lumen.<br />

3. Using current hospital protocol, connect a standard arterial pressure<br />

flush apparatus to the hub of the inner lumen. A continuous 3cc/<br />

hour flow through the inner lumen is recommended.<br />

2<br />

BALLOON<br />

Figure 21<br />

NOTES<br />

WARNING<br />

NEVER INJECT AIR INTO THE INNER LUMEN (female luer hub).<br />

PRECAUTION<br />

If the inner lumen has been capped off DO NOT attempt to re-access<br />

the inner lumen.<br />

4. Release the vacuum from the <strong>IAB</strong> catheter by removing the oneway<br />

valve from the <strong>IAB</strong> catheter male luer fitting. (See Figure 21)<br />

MALE LUER FITTING<br />

EXTRACORPOREAL TUBING<br />

ONE-WAY VALVE<br />

5. Connect the <strong>IAB</strong> catheter to the pump.<br />

Ensure that all connections are leak-free.<br />

All catheter extenders are sterile and should only be used one time.<br />

Use one catheter extender when connecting the <strong>IAB</strong> catheter to the <strong>IAB</strong><br />

pump.<br />

When connecting the SENSATION <strong>IAB</strong> to a MAQUET/<br />

Datascope ber-optic <strong>IAB</strong>P:<br />

a. Connect the <strong>IAB</strong> catheter’s male luer fitting to the female luer fitting<br />

of the catheter extender. Connect the male luer fitting of the catheter<br />

extender to the safety chamber/disk.<br />

b. Completely remove the cable wrap securing the optical sensor <strong>IAB</strong><br />

cable.<br />

c. Carefully uncoil the optical sensor cable by loosely holding the coiled<br />

cable in one hand. With the other hand, grasp the optical sensor<br />

connector and slowly pull to uncoil the cable.<br />

PRECAUTION<br />

Take care not to kink the optical sensor cable to avoid damage.<br />

6. Using the following steps, attach the optical sensor <strong>IAB</strong> cable<br />

connector to the <strong>IAB</strong>P:<br />

NOTE: Always grasp the optical sensor cable connector to insert OR remove<br />

the connector from the pump as shown in Figure 22.<br />

PRECAUTION<br />

DO NOT touch the exposed end of the Optical Sensor cable, or permit<br />

it to contact other surfaces. This could damage or contaminate the<br />

sensor connection.<br />

a. With one hand, grasp the <strong>IAB</strong>’s optical sensor cable connector as shown<br />

in Figure 22. Note that the red mark on the connector should be up.<br />

b. With the other hand, remove and discard the protective cover from<br />

the <strong>IAB</strong> optical sensor cable connector.<br />

Figure 22<br />

Figure 23<br />

BALLOON<br />

c. With free hand, slide open the protective shutter located on the<br />

pump’s rear panel by sliding it to the left to expose the <strong>IAB</strong>P Sensor<br />

Input. Keep the shutter door open until connection is complete.<br />

(See Figure 23)<br />

d. Insert the optical sensor connector into the <strong>IAB</strong>P’s Sensor Input<br />

receptacle. The connector should be inserted until it “clicks”. DO NOT<br />

touch the exposed end of the Optical Sensor Cable. (See Figure 23)<br />

e. For securement connect the Sensor <strong>IAB</strong> cable to the tubing clips<br />

located on the catheter extender tubing.<br />

SENSOR<br />

<strong>IAB</strong> CABLE<br />

<strong>IAB</strong> <strong>CATHETER</strong><br />

EXTENDER

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