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Dialysis
Access
1
Vascular System
Superior
Vena Cava
Internal Jugular Vein
External Jugular Vein
Brachlocephalic Vein
Subclavian Vein
Cephalic Vein
Axillary Vein
Brachial Vein
Inferior
Vena Cava
2
What is Kidney Failure?
Less than 10% kidney function
Sudden condition
Acute
Often temporary
Slower onset
Chronic
Not reversible
3
What causes Kidney Failure?
Diabetes
High blood pressure
Inflammation
Blockage
Chronic infection
Heriditary
Other
4
How do you treat Kidney Failure?
Kidney transplant
Haemodialysis
Continuous ambulatory peritoneal dialysis
Automated peritoneal dialysis
5
What happens during a
Haemodialysis Session?
Blood with
waste to
dialyser
Access
Cleaned
blood back
to the body
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Fistula Access
Arterial line
Venous line
Fistula
Vein
Artery
Vein
Radial
artery
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Jugular Catheter
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What is Peritoneal Dialysis?
New solution
Tubing set
Used solution
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Peritoneal Dialysis Catheter
Catheter
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What is CAPD?
Constant dialysis
24 hours a day
Continuous
Ambulatory
You can walk
around while it’s
happening
Peritoneal
Dialysis
Peritoneal membrane
works as a filter
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CAPD exchange
Drai
n
Used
solution
Dwel
l
Fill
New
solution
Remove
tubing set
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8 French Single Lumen Catheter
Recommended
for acute
hemodialysis
• Acute haemodialysis
• low-cost
• 8 French
• Single Lumen
• choice of straight or curved extension,
• singles and kits, and
• radiopaque polyurethane
•Five outflow holes spiral near the tapered tip to help prevent occlusion
against the vessel wall.
• rotatable suture wing facilitates suturin
• luer-lock adapter optimises connections.
• Priming volumes are conveniently printed on the extensions to aid in
accurate heparinization.
13
Quinton Haemodialysis Catheters
Recommended
for acute
hemodialysis
• Acute or Chronic haemodialysis
• single, double, or triple lumen catheters
• Mahurkar design = optimal flow UNIQUE
• silicone extensions
• unbreakable clamps
• Priming volumes printed on extensions
• choice of straight or curved extension,
• singles and kits
• Luer lock adapters
•Polyurethane acute
•Silicone chronic
• tapered atraumatic tip
• rotatable suture wing facilitates suturin
• luer-lock adapter optimises connections.
• subclavian, jugular, femoral placement
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8 French Single Lumen Catheter
Adaptable
Recommended
for acute
hemodialysis
An optional, disposable Y-adapter lets you convert the single extension
catheter to a dual.
Percutaneous Insertion
The catheter can be inserted percutaneously into the subclavian,
femoral, or jugular vein.
Catheter Kit
8 French Single Lumen Catheters are available in time-saving,
cost-efficient Catheter Kits.
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Mahurkar Dual Lumen Catheter
Recommended
for acute
hemodialysis &
apheresis
• 8, 10 or 11.5 Fr. diameter,
• curved or straight extensions
• Singles and Kits
Patented Design
Made of flexible polyurethane,
Quick insertion
patented double-D lumina = high flow rates (300 to 350ml/ min)
tip design helps minimize recirculation.
Rotatable Suture Wing
helps stabilize the catheter
enables the tip to be rotated after implant without removing sutures
transparent
angled away from the exit site
Easy to see exit site
Easy to clean area
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Mahurkar Dual Lumen Catheter
Imprinted Extensions
Recommended
for acute
hemodialysis &
apheresis
catheter’s name
Length
priming volumes
Optional Curved Extensions
patented curved extensions (jugular placements)
Catheter Kit
time-saving
cost-efficient
convenient
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PermCath Dual Lumen Catheter
short- and long-term
Efficient
Recommended
for
hemodialysis,
apheresis &
infusion
2.5cm separation between the arterial lumen and the venous tip helps
reduce recirculation
Priming volumes are printed on the clear extensions.
Comfortable
silicone
felt cuff anchors the catheter subcutaneously
helps establish a natural infection barrier.
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PermCath Dual Lumen Catheter
Choice of Insertion Sites
Recommended
for
hemodialysis,
apheresis &
infusion
jugular, subclavian, or femoral vein.
40cm and 45cm catheters permit access to the right atrium from the
patient’s left side. They are particularl
useful for larger patients, when the right side is thrombosed, or for a
thoracic approach.
Catheter Kit
patented Oval Pull-ApartTM sheath/dilator
Oval Pull-ApartTM Introducer Set
conforms to catheter shape = reduces risk of air embolism during
insertion.
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PermCath Dual Lumen Catheter
Oval Pull-Apart Introducer
Extra Oval Pull-Apart sheath/dilators are available.
Catheter Repair Kit
Recommended
for
hemodialysis,
apheresis &
infusion
Catheter Repair Kits eliminate the need to replace a catheter due to
external damage.
Repair Kits are available in all PermCath sizes.
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Mahurkar 13.5 Fr Cuffed Catheter
Efficient
Recommended
for
hemodialysis
2.5 cm separation between the arterial lumen and the venous tip helps
reduce recirculation
Priming volumes are printed on the clear extensions.
Choice of Insertion Sites
jugular, subclavian or femoral vein.
40cm, 45cm and 50cm catheters permit access to the right atrium from
the patient’s left side.
useful for larger patients, when the right side is thrombosed, or for a
thoracic approach.
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Mahurkar 13.5 Fr Cuffed Catheter
Comfortable
Recommended
for
hemodialysis
silicone rubber, the catheter does not abrade the skin at the exit site or
interfere with
patient mobility. The flexible silicone suture wings anchor the catheter
while tissue ingrowth occurs.
A felt cuff anchors the catheter subcutaneously and helps establish a
natural infection barrier
Catheter Kit
The catheters are available in time-saving, cost-efficient Kits. They
contain the basic items needed for percutaneous insertion and a
convenient tunnelling stylet.
Catheter Repair Kits
Catheter Repair Kits eliminate the need to replace catheters, due to
external damage. Repair Kits are available in all catheter lengths.
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MAHURKAR Acute Triple Lumen Catheter
Safety
• Soft Atraumatic Tip designed to
reduce vessel trauma during
insertion
Recommended
for
hemodialysis,
apheresis and
infusion
• Laser Cut Arterial Slot reduces
positional occlusion, maintains
high flows and retains heparin
lock
• Imprinted Primimg Volumes on
catheter extensions quickly
identify heparin loading volumes
• Straight Infusion Lumen
differentiates it from the dialysis
ports to prevent accitental infusion
of heparin or Urokinase
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MAHURKAR Acute Triple Lumen Catheter
Ease of use
• 180° Curved Extensions help
stabilize the catheter and aid in
patient comfort
Recommended
for
hemodialysis,
apheresis and
infusion
• Rotatable Suture Wings enable the
tip to be rotated after implantation
and stabilize the catheter
Selection
• The 12 Fr. Mahurkar Acute Triple
Lumen Catheter is available in four
lengths: 13 cm, 16 cm, 20 cm and
24 cm to accommodate varying
body types and insertion sites
• Catheters are available individually
or in kits
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MAHURKAR
Acute
Triple
Lumen
Catheter
Recommended
for
hemodialysis,
apheresis and
infusion
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Tenckhoff Peritoneal Catheters
Broad Selection
Recommended
for peritoneal
dialysis or
intraperitoneal
chemotherapy
Choose from a variety of catheter lengths and cuff placements, or
choose Quinton’s Universal
Tenckhoff- a unique catheter that can be trimmed to fit most patient
sizes. Quinton offers the
Tenckhoff in four cuff configurations:
two attached cuffs - one subcutaneous and one preperitoneal,
one attached cuff - in either the subcutaneous or preperitoneal
position, and
two loose cuffs - catheter can be customized to fit the needs of the
patient.
Cost-Efficient
For your convenience, Quinton packages Tenckhoff catheters one per
carton, enabling you to stock multiple configurations at minimal cost.
Catheters are also available in time-saving, cost-efficient Kits. They
contain the basic items needed for percutaneous insertion, featuring
the Pull-ApartTM sheath/dilator and tunnelling stylet.
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Tenckhoff Peritoneal Catheters
Complete System
Recommended
for peritoneal
dialysis or
intraperitoneal
chemotherapy
Each Tenckhoff catheter comes with an adapter, cap, and clamp. The
Ultem® adapter forms a tight closure with standard CAPD transfer sets
and eliminates the need for expensive titanium adapters.
In Addition
Quinton makes Curled Peritoneal Catheters, Peritoneal Catheter Kits,
and catheter accessories.
Catheter Repair Kit
The Peri-Patch® and Peritoneal Catheter Repair Kits provide the
components for fast, convenient
Tenckhoff repair. Unlike polyurethane catheters, the silicone-rubber
Tenckhoff can be extended
or repaired, thereby eliminating the need for costly replacement due to
external damage.
To calculate the internal volume of the catheter, multiply .058 by the
length of the catheter.
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Tenckhoff Peritoneal Catheters
Recommended
for peritoneal
dialysis or
intraperitoneal
chemotherapy
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Curl Cath Peritoneal Catheters
Features
Recommended
for peritoneal
dialysis or
intraperitoneal
chemotherapy
The Curl Cath Catheter, a modified Tenckhoff, is suitable for acute or
chronic peritoneal dialysis and intraperitoneal chemotherapy. It can be
inserted either percutaneously or surgically.
The additional mass of the Curl Cath keeps the catheter low in the
pelvic gutter, resulting in fewer dislodgements and less catheter
migration. The catheter’s curled tubing and numerous inflow/outflow
holes diffuse dialysate gently into the patient.
The Curl Cath is made of translucent, medical-grade silicone rubber
with a radiopaque stripe. It has a 4.9mm OD., and a 2.6mm ID., and
comes in adult or pediatric lengths. Unlike polyurethane catheters, the
Curl Cath can be extended or repaired if necessary, eliminating the
need for costly catheter replacement due to external damage.
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Curl Cath Peritoneal Catheters
Recommended
for peritoneal
dialysis or
intraperitoneal
chemotherapy
Felt cuffs anchor the catheter subcutaneously and help establish a natural
infection barrier through tissue ingrowth. To meet the varying needs of
patient and physician, Quinton offers four cuff configurations:
• two attached cuffs - one subcutaneous and one preperitoneal,
• one attached cuff - in the preperitoneal position, and
• two loose cuffs - the clinician can customize cuff placement on the
catheter to meet the needs of the patient.
The adapter provides a tight closure with standard CAPD transfer sets and
eliminates the need for expensive titanium adapters.
Curl Cath Catheters are also available in convenient Kits, which provide
the necessary components for inserting the catheter by modified Seldinger
technique. Each Kit features a Pull-ApartTM Introducer and Peritoneal
Catheter Tunnelling Stylet.
Accessories
Quinton offers a full line of accessory items for Curl Cath catheters,
including repair kits, and stylets. See our Peritoneal Catheter Accessories
and Peri-Patch® data sheets for ancillary and replacement components.
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Swan Neck Peritoneal Catheters
Recommended
for peritoneal
dialysis
Swan Neck Specialty Peritoneal Catheters give you the
options and features you need to simplify access for
peritoneal dialysis.
•
•
•
•
•
•
•
•
Broad Selection
Choose from a Variety of Catheter Options:
Tenckhoff
Curl Cath
Missouri (Available in Tenckhoff and Curl Cath)
Oreopoulos-Zellerman or Toronto Western (Available in
Tenckhoff and Missouri)
Presternal (Available in Curl Cath)
Some are available in pediatric
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Swan Neck Peritoneal Catheters
Recommended
for peritoneal
dialysis
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Swan Neck Peritoneal Catheters
Recommended
for peritoneal
dialysis
33
Swan Neck Peritoneal Catheters
Recommended
for peritoneal
dialysis
34
Swan Neck Peritoneal Catheters
Recommended
for peritoneal
dialysis
35
Swan Neck Peritoneal Catheters
Recommended
for peritoneal
dialysis
36
Peritoneal Catheter Kit
Recommended
for
percutaneous
placement of
Peritoneal
Catheters
37
Peritoneal Catheter Kit
Percutaneous Insertion
Recommended
for
percutaneous
placement of
Peritoneal
Catheters
The Peritoneal Catheter Kit provides an ideal alternative
to catheter placement by laparotomy. Each Kit features a
Pull-Apart Introducer used to insert the catheter
percutaneously using modified Seldinger technique. This
technique involves a smaller incision, helping to
minimize the risk of post-operative dialysate leakage, and
often enabling the catheter to be used sooner. In general,
percutaneous insertion means faster insertion and
greater patient comfort.
38
Peritoneal Catheter Kit
Convenience
Recommended
for
percutaneous
placement of
Peritoneal
Catheters
Cost-efficient Kits simplify inventory and save staff time required for
assembling supplies needed for catheter insertion. Each Kit contains
the following components:
• peritoneal catheter,
• BetaCap adapter, cap and clamp,
• 1 6Fr. Pull-Apart sheath/dilator,
• 18 gage introducer needle,
• J/straight guide wire,
• 10cc syringe,
• #11 scalpel,
• tunnelling stylet, and
• gauze sponges.
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Peritoneal Catheter Kit
Complete System
Recommended
for
percutaneous
placement of
Peritoneal
Catheters
Each catheter comes with a Beta-Cap adapter, cap, and clamp. The
Ultem adapter forms a tight closure with standard CAPD transfer sets.
Choices
•
•
•
•
•
variety of lengths (42, 57, 60 and 62cm)
styles (straight, curled, and universal)
cuffed positions (single, dual, preperitoneal, or subcutaneous)
styles (straight or curled, universal and straight or curled Swan Neck)
catheter stencils (Available for Swan Neck)
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Peri-Patch Repair Kit
The Peri-Patch® Repair Kit contains:
• 15cm silicone rubber catheter extension (2.6mm ID., 4.9mm CD.) with
Recommended
for lengthening
and repair of the
external portion
of Peritoneal
Catheters
•
•
•
double-barbed connector;
Beta-Cap® adapter, cap, and clamp;
medical-grade silicone adhesive, Type A; and
glue mold.
The hinged glue mold with locking ring is approximately 5cm long. Used
with the adhesive, the mold forms a permanent silicone seal over the
connection between the indwelling catheter and the extension.
NOTE: To be repaired, the indwelling catheter needs to have at least 3cm
external tubing at the exit site.
All components, including silicone adhesive are supplied sterile. Kits are
double packaged; the inner package can be placed directly on a sterile
field. Due to the expiration date, the adhesive is packaged separately in a
sterile pouch.
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Peritoneal Catheter Accessories
Peritoneal Catheter Straightening Stylet
Tyco Healtcare
offers top
quality
accessories for
its peritoneal
catheters
The stainless steel stylet is 62cm long, helping to keep the catheter
straight and manoeuvrable during insertion into the peritoneum.
Peritoneal Tunnelling Stylet
The Stylet penetrates tissue cleanly, creating a subcutaneous tunnel
with minimal bleeding and tissue trauma. As the stylet dilates the
tissue, the practitioner simultaneously pulls the catheter through the
tunnel. Made of pliable stainless steel, it can be bent to create a
customized, curved tunnel. The stylet is 5Fr. x 23cm (9”).
Felt Cuffs
Felt Cuffs enable the practitioner to custom fit Quinton® Peritoneal
Catheters. They anchor the catheter and help establish a natural
infection barrier. Each cuff is one centimetre long.
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Peritoneal Catheter Accessories
Medical Grade Silicone Adhesive Type A
Tyco Healtcare
offers top
quality
accessories for
its peritoneal
catheters
The sterile adhesive is used to bond felt cuffs to the catheter. It is also
used with Quinton® Repair Kits to extend or repair catheters.
Injection Sealing Caps
Caps provide self-sealing injection sites for administering medications.
Beta-Cap® Adapter
The Beta-Cap adapter is made of Ultem® resin and can be used with all
Quinton® Peritoneal Catheters. It forms a tight closure with standard
CAPD transfer sets and eliminates the need for expensive titanium
adapters.
Beta-Cap® Clamp
The Beta-Cap Clamp is compatible with all Quinton® Peritoneal
Catheters.
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Single Lumen Right Atrial Catheter
Advantages
Recommended
for long term
infusion and
blood sampling
Single Lumen Right Atrial Catheters provide long-term vascular access
with minimal
trauma to the system. Made of soft, biocompatible silicone rubber, these
radiopaque
catheters are ideal for immunosuppressed, thrombocytopenic patients
needing:
•
•
•
•
chemotherapy,
total parenteral nutrition,
blood sampling, or
blood product administration.
44
Single Lumen Right Atrial Catheter
Features
Recommended
for long term
infusion and
blood sampling
•
•
•
•
•
•
•
reinforced tubing to protect the catheter when clamping
felt cuff to anchor the catheter subcutaneously and help establish a
natural infection barrier
range of sizes
catheter name and priming volume are imprinted on extensions for
easy identification
can be inserted percutaneously using a Pull-ApartTM sheath/dilator
or surgically implanted
in-line clamp and luer-lock adapter
atraumatic tunnelling stylet designed to minimize bleeding in the
tunnel tract
45
Single Lumen Right Atrial Catheter
Catheter Repair Kit
Recommended
for long term
infusion and
blood sampling
Catheter Repair Kits eliminate the need to replace a catheter due to
external damage.
46
Raaf Dual Lumen Right Atrial Catheter
Advantages
Recommended
for long term
infusion and
blood sampling
Single Lumen Right Atrial Catheters provide long-term vascular access
with minimal
trauma to the system. Made of soft, biocompatible silicone rubber, these
radiopaque
catheters are ideal for immuno suppressed, thrombocytopenic patients
needing:
• chemotherapy,
• total parenteral nutrition,
• blood sampling, or
• blood product administration.
47
Raaf Dual Lumen Right Atrial Catheter
Features
Recommended
for long term
infusion and
blood sampling
•
•
•
•
•
•
•
reinforced tubing to protect the catheter when clamping
felt cuff to anchor the catheter subcutaneously and help establish a
natural infection barrier
range of sizes
catheter name and priming volume are imprinted on extensions for
easy identification
can be inserted percutaneously using a Pull-ApartTM sheath/dilator
or surgically implanted
in-line clamp and luer-lock adapter
atraumatic tunnelling stylet designed to minimize bleeding in the
tunnel tract
48
Raaf Dual Lumen Right Atrial Catheter
Catheter Repair Kit
Recommended
for long term
infusion and
blood sampling
Catheter Repair Kits eliminate the need to replace a catheter due to
external damage.
49
3.9 mm Triple Lumen Catheter
Recommended
for
chemotherapy,
stem cell
infusion,
parenteral
nutrition,
incompatible
therapeutic
agents, blood
sampling and
transfusions
Minimal Trauma
Made of biocompatible, soft silicone rubber, the catheter minimizes
internal trauma, making it ideal for immunosuppressed,
thrombocytopenic patients.
Percutaneous Insertion
The catheter can be surgically implanted, or it can be introduced
percutaneously through a 1 2Fr. Pull-ApartTM Introducer. A felt cuff
anchors the catheter subcutaneously and helps create a natural infection
barrier.
Extras
For your convenience, the catheter has clear extensions to enable you to
see blood or air in the tube, in-line clamps, and color-coded, luer-lock
adapters. The larger 1 .2mm lumen, used for blood products, is
conveniently identified by its red adapter.
50
3.9 mm Triple Lumen Catheter
Recommended
for
chemotherapy,
stem cell
infusion,
parenteral
nutrition,
incompatible
therapeutic
agents, blood
sampling and
transfusions
Catheter Repair Kit
The Catheter Repair Kit eliminates the need to replace a catheter due to
external damage.
51
Welcome to the Tyco test
1. What material are Acute Mahurkar Catheters
made from?
2. What material are Permcath Catheters made from?
3. What are the extensions made of?
4. What material do our competitors use for the
extensions?
5. Which catheters need a tunnel?
6. Which substance is used for priming?
7. Which substance is used for anti-clotting?
8. Please state the three major placements in the body
for HD catheters?
9. List the name of three competitors in your market
52
Welcome to the Tyco test
continued
10. Quinton configurations on extensions: How many and
their names?
11. How many cuffs on a PD catheter?
12. Which are the two major insertion methods of a HD
catheter?
13. Describe the Seldinger technique in point form (step by
step).
14. Where should the tip of the Permcath catheter be
placed?
15. Which Quinton catheter has suture wings?
16. What is the special benefit of the Quinton suture wing?
17. Where should the tip of a Mahurkar catheter be placed?
18. What are DOQI guidelines?
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Your happy boss?
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