Idiomas disponibles
Idiomas disponibles
F. Prime the Bolus Channel with Sodium Chloride Solution
Refer to Figure 7 and follow Steps 1 through 4 to prime the bolus channel
of the pump and the pump catheter with preservative-free sterile solution
of 0.9% sodium chloride.
Required materials:
10 mL syringe
Components from the O.R. prep kit:
filter
connecting tube
bolus needle (purple hub)
10 mL preservative-free sterile solution of 0.9% sodium chloride
1.
Fill the 10 mL syringe with the sodium chloride solution. Expel the air
from the syringe. Connect the syringe to the filter retained from filling the
pump reservoir.
2.
Connect the filter to the connecting tube. Connect the bolus needle to the
free end of the connecting tube. Expel the air from the assembly; then expel
5 mL of the sodium chloride solution to flush the drug solution remaining in
the assembly.
3.
Holding the needle perpendicular to the pump, puncture the bolus
port. Insert the needle until it contacts the needle stop; twist the needle
to make sure it completely penetrates the silicone bolus channel beneath the
bolus port.
4.
Inject the sodium chloride solution. Liquid must exit the end of the pump
catheter (or the outlet port, if the pump catheter is not being used). Remove
the needle from the port and discard the assembly.
Note: If liquid does not exit the catheter, check the following:
•
The bolus needle might not be inserted completely. Repeat Step 3.
•
The bolus needle might be clogged. Remove the needle and check
its function.
•
The catheter might be clogged or attached incorrectly. Check the connection of
catheter to pump outlet; check the patency of the pump catheter.
16
IMPLANTATION PROCEDURE
A. Replace an Implanted Pump
If replacing a MedStream pump, follow Steps 1 through 5.
1.
Prepare the new pump as described in the previous sections
(Clean Procedures and Sterile Procedures).
2.
Remove the old pump by cutting the intraspinal catheter near the connection
to the pump catheter.
3.
Use a small syringe, such as a 1 mL tuberculin syringe, to aspirate 1 to 2 mL of
fluid from the intraspinal catheter. Leave the syringe in the catheter to prevent
loss of CSF. Removing the catheter contents will help prevent the possibility of
overdose and will confirm that the catheter is patent.
4.
Implant a new catheter, if the existing catheter is not patent.
5.
Proceed to C. Secure the Pump and D. Connect the Intraspinal Catheter.
B. Prepare the Pump Pocket
After the pump has been prepared for implantation, prepare the pump pocket at an
appropriate location in the abdomen.
CAUTION: In the pediatric patient, take care to select an appropriate location for
the pump pocket. Take these factors into consideration:
•
available body mass
•
presence of ostomies
•
future growth and development
C. Secure the Pump
Use non-absorbable suture to secure the pump to the fascia in the appropriate
manner. Ensure that the pump will lie not more than 2.5 cm below the surface
of the skin, with the central port facing towards the skin, and that it can be
easily palpated.
