D. Connect the Intraspinal Catheter
Use the steps in this section when attaching a CODMAN Intraspinal Catheter to
the MedStream pump catheter. Follow the instructions packaged with the catheter
if you are connecting the CODMAN Intraspinal Catheter directly to the MedStream
pump outlet, without using the pump catheter.
If you are using the SureStream Intraspinal Catheter and its specially designed
connector, follow the instructions packaged with that catheter.
1.
Implant the intraspinal catheter in the spine in accordance with the
instructions for use packaged with the catheter. Pass the catheter
subcutaneously to the pump pocket.
2.
Trim the pump catheter and intraspinal catheter as needed. Leave an extra
amount of catheter to allow for patient movement before trimming.
CAUTION: Make note of the amount of pump catheter and intraspinal
catheter that are removed. This information is required for programming the
pump later in the procedure.
3.
Position excess pump catheter in a loose loop underneath the pump.
4.
Slide the white-ringed (smaller diameter) end of the strain relief sleeve
approximately 4 cm over the intraspinal catheter.
5.
Insert the catheter connector into the end of the intraspinal catheter and the end
of the pump catheter. Ensure that the catheters contact the center step of
the connector.
6.
Slide the strain relief sleeve over the junction of the catheters until the sleeve
bottoms out on the connector step.
7.
Tie ligatures of No. 0 silk suture in the suture grooves of the sleeve in order to
secure the sleeve to the catheters.
POSTOPERATIVE PROCEDURES
A. Program the Pump
CAUTION: Be aware that the pump will not begin to deliver the drug solution
until you use the control unit to initialize and program patient therapy into
the pump.
Follow the instructions in the MedStream Programming Guide to enter patient
identification, catheter information and drug information into the pump memory.
Then program the drug delivery profile. Optional: program a bridge bolus to fill the
catheter(s) with drug solution and immediately begin infusion therapy.
Follow the instructions in the MedStream Programming Guide to perform therapy
maintenance, such as changing the drug deliver program.
B. Patient Identification
Patient identification cards are included with the pump. Please select the
appropriate language card for your patient and enter the information on the back
side of the card. Instruct the patient to carry this card at all times.
C. Schedule the First Refill
After you have programmed the drug delivery program, the pump will calculate the
refill date. To retrieve this information, use the control unit to interrogate the pump
again. This will display the summary, which includes the refill date. Schedule a refill
appointment several days before the refill date.
Follow the MedStream Programming Guide and use a MedStream Refill Kit when
refilling the reservoir.
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