Pourchez XpressO®/RetrO®
Site Care/Heparinization Recommendations

The following are guidelines and recommendations for the care of the Pourchez XpressO®/RetrO® exit site. Among the key recommendations are:

• Acetone or Iodine based solutions should not be used.
• A wide variety of antiseptic solutions can be used.
• Heparin priming volume is located on each catheter extension.
• Institutional protocol should be followed for the correct heparin concentration.
• Notify a physician if aspiration of a clot fails or if there is redness, swelling or drainage noted at the exit site.

In general, recommendations for the care, cleaning and heparinization of the XpressO®/RetrO® are similar to other catheters except for the antiseptic solutions that can be used.

Pourchez XpressO®/RetrO®
Site Care Recommendations

Completely clean the entire skin area around the catheter. Be sure to cover the catheter exit site and the silicone extensions of the catheter. Cover site with occlusive dressings applied per institutional protocol. The dressing must be changed in sterile conditions. Please note that wound dressing must be kept dry. A catheterized patient must not swim, shower or soak dressing area during bathing. Do not use Acetone or Iodine based solutions on any part of the catheter tubing. Alcohol based solutions, Chlorhexidine Gluconate (Hibiclens®), Electrolytic Chloroxidizer (ExSept), Bacitracin Ointment, Isopropyl Alcohol 70%, Hydrogen Peroxide, or regular Clorox Bleach are recommended as antiseptic solutions that can be used for exit site care. Assess for potential infection. Notify a physician if redness, swelling or drainage is noted at the exit site.

Catheter Care and Precautions

Use extreme caution when using sharp instruments near extension lines or the catheter tubing. Avoid using scissors to remove dressing as they may cut or damage the catheter. Do not suture through any part of the catheter. The catheter tubing can tear when subjected to excessive force, sharp cuts or rough edges. Avoid clamping the shaft of the catheter. Clamp on the silicone extension only. Make sure to examine tubing for any damage after each treatment. Tape injection caps between treatments. Do not over-tighten bloodlines, syringes or caps. Inspect catheter frequently for nicks, scrapes, cuts or other damage, which could affect treatment and performance.

Heparinization Guidelines

Always follow the standard institutional protocol. The following guidelines may be helpful:

• Inject heparin solution into each lumen of the catheter. When injecting the heparin, inject rapidly to ensure that it completely fills each lumen. The total volume of each heparin solution should be equal to the internal volume of each lumen (refer to priming volume on each catheter extension).
• Clamp the arterial and venous extensions, remove syringe, and attach a sterile injection cap to each luer lock connector. Keep the extensions clamped.
• Ensure that sufficient heparin concentration is used. Please consult your institution protocol to verify the correct heparin concentration.
• To prevent systemic heparinization, aspirate at least 3 ml. from each catheter lumen prior to use.
• Never forcibly flush a clotted lumen. If either lumen develops a thrombus, first attempt to aspirate the clot with a syringe. If aspiration fails, consult a physician.