Removel Procedure

Question 1

Step 1 in removal procedure

Answer 1

Ensure sterile field is prepared in accordance to instructions

Question 2

Step 2 in removal procedure - patient questions 1-4

Answer 2

Discuss patient satisfaction with placement location

• will it be in the same location, or another
• if new, follow steps for new site
• ask patient about known allergies to antiseptic or anesthesia agents
• ask patient for concomitant anticoagulant use

Question 3

Step 3 in removal procedure

Answer 3

Palpate to locate ITCA 650

If cannot be grasped and immobilized, contact corp

Question 4

Step 4 in removal procedure

Answer 4

Mark end of ITCA 650 for removal incision and make a guiding mark 6cm from removal site on opposite end of ITCA 650

Question 5

Step 5 in removal procedure

Answer 5

Clean quadrant with three chlorhexidine swabs - 8” circles

Question 6

Step 6 in removal procedure

Answer 6

Wash hands and put on sterile gloves

Question 7

Step 7 in removal procedure

Answer 7

Place fenestrated drape over removal site - long end parallel to belt line

Question 8

Step 8 in removal procedure

Answer 8

Load ITCA 650
Keep blue actuator button forward/bevel of cannula up
Insert ITCA into cannula until 1cm remains protruding
Use mosquito forceps to push in till 1mm remains protruding

Question 9

Step 9 in removal procedure

Answer 9

Draw anesthetic
Draw 10ml of lidocaine from vial with assistance to hold vial
Replace 22g needle with 25 g needle

Question 10

Step 10 in removal procedure

Answer 10

Immobilize and Tent
Grasp ITCA with non dominant hand
Immobilize and tent proximal end over mosquito forceps where incision will be made
Use forefinger or middle finger to apply constant pressure on distal end

Question 11

Step 11 in removal procedure

Answer 11

Apply anesthetic only at end of device where incision will be made
Do not use as much as initial placement

** do not activate safety mechanism on needle, more anesthetic will be needed later

Question 12

Step 12 in removal procedure

Answer 12

Incision - make small semicircular incision
2-3 mm back from tented end
Down through fibrous tissue to expose metal tip of ITCA
Continue with pressure towards mosquito forceps to promote expulsion

Question 13

Step 13 in removal procedure

Answer 13

Grasp ITCA, once visible, with mosquito forceps

*NEVER USE FORCEPS TO EXPLORE FOR ITCA