Day 1: Pinnacle Portfolio (ESM)

Question 1

What is an introducer kit?

Answer 1

A flexible, sterile tube inserted into the patients’ body to allow access for the insertion of instruments and/or medication into an artery or vein and to maintain hemostasis.

Question 2

What components make up an introducer sheath?

Answer 2

• mini guidewire
• dilator
• sheath
• French size indicator
• side tube
• 3-way stop cock

Question 3

What colors correspond to the French sizes?

Answer 3

Red = 4 fr
Gray = 5 fr
Green = 6 fr
Orange = 7 fr
Sky blue = 8 fr
Midnight = 9 fr
Lavender = 10 fr
Sun flower = 11 fr

Question 4

What does sheath French relate to?

Answer 4

The inner diameter. Therefore it will be __ fr or less to me compatible. The sheath French is less than or equal to.

Question 5

What does catheter French relate to?

Answer 5

The outer diameter. therefore if it is __ fr or larger it will be compatible. The catheter French is greater than or equal to.

Question 6

What is a hematoma?

Answer 6

A collection of blood in soft tissue. It is the most common VAC.

Question 7

How does a hematoma form?

Answer 7

Multiple sticks, back wall puncture, improper puncture site, poor sheath, poor artery compression, anti coagulation, high blood pressure or failed closure device.

Question 8

What is an AV Fistula?

Answer 8

An abnormal connection between an artery and vein.

Question 9

What causes AV Fistulas?

Answer 9

A track from a high pressure artery to a low pressure vein. Typically associated with sticks below the SFA and Profunda bifurcation.

Question 10

What is pseudoaneurysm?

Answer 10

When blood pools and is contained in the soft tissues outside of the vessel wall (looks like a bubble) after injury. Pseudo means fake, because it is not naturally made by the body.

Question 11

What causes a pseudoanuerysm?

Answer 11

Vessel wall injury from multiple punctures or a puncture below the SFA and Profunda bifurcation.

Question 12

What is a Retroperitoneal (RP) bleed?

Answer 12

Deep internal bleeding into the peritoneum.

Question 13

What causes an RP bleed?

Answer 13

typically occurs when access is obtained above the inguinal ligament and the back wall is punctured.

Question 14

What are our two Micro Access Kits?

Answer 14

Precision and Glideaccess

Question 15

What are our two standard sheaths?

Answer 15

Pinnacle and Pinnacle TIF Tip.

Question 16

What are our two Radiopaque sheaths?

Answer 16

R/O II and R/O II HiFlow

Question 17

What does TIF Tip stand for?

Answer 17

Total Integrated Fit - less penetration force

Question 18

What is the size of the radiopaque marker and R/O II and where is it placed?

Answer 18

1mm marker band is placed 5mm from the distal tip.

Question 19

What is the length of the R/O II HiFlow sheath and what is it most commonly used for?

Answer 19

4cm and it is commonly used for AV Fistula and dialysis access work.

Question 20

What needle and wire come in the standard Glideaccess MAK?

Answer 20

21G needle and 018 wire.

Question 21

What needle and wire come in the Precision MAK?

Answer 21

21-19G tapered needle with 021 wire.

Question 22

What are the F&Bs of the Precision needle?

Answer 22

Tapered for smoother insertion and better back flow
Back beveled cut for sharper puncture
Echogenic spiral cut for better visibility

Question 23

What are the steps for standard micro access?

Answer 23

1) insert 21G needle
2) thread 018 wire
3) remove needle leaving wire
4) insert micro dilator OTW
5) remove wire and inner dilator, leave outer
6) insert 035 wire
7) remove outer dilator
8) place sheath
9) remove 035 wire and dilator leaving sheath

Question 24

What are the steps for Precision access?

Answer 24

1) insert tapered 21-19G needle
2) thread 021 wire
3) remove needle
4) insert sheath OTW
5) remove dilator and wire, leaving sheath