SAF Nursing Reference Card

Nursing Quick Reference Guide
ON-Q® C-bloc®
provides a continuous infusion of a local anesthetic near a
nerve for regional anesthesia and postoperative pain management. The system
consists of an elastomeric pump filled with a local anesthetic. The pump is
connected to a catheter that has been placed next to a nerve near the surgical
area. The pump is completely portable and may be attached to the patient’s
clothing, carried in a sling or placed in a carrying pouch.
ON-Q C-bloc with ONDEMAND™ incorporates a bolus device,
which allows fixed boluses to be delivered upon demand by the patient or
healthcare provider. The pump also delivers a continuous infusion (basal).
ON-Q C-bloc with Select-A-Flow ® contains a variable rate
controller that enables the flow rate to be changed by turning the dial.
ON-Q C-bloc with Select-A-Flow & ONDEMAND contains a
variable rate controller combined with a bolus device.
24-Hour Product Support Hotline 800.444.2728
MANAGING THE INFUSION
INFUSION STATUS
• Due to slow flow rate, a change in
the appearance and size of pump
may not be evident for more than
24-30 hours after surgery.
PUMP
• A fluid level line will not be visible
in the pump. The pump tubing will
look clear and medication will not
be seen moving through the tubing.
SELECT-A-FLOW ®
CLAMP
• Over time, outside bag on pump will
become looser and creases will begin
to form in the bag.
FILTER
• As medication is delivered, pump
balloon will gradually become smaller.
ATTACHES TO
CATHETER
ONDEMAND™
Pump appearance
after approximately
24 hours
PATIENT MONITORING
TUBING
• If any of the following symptoms are assessed, close the
tubing clamp and notify the physician immediately:
Increase in pain
Fever, chills, sweats
FLOW
CONTROLLER
Bowel or bladder changes
Difficulty breathing
FIXED FLOW RATE
May be covered by the dressing
edness, warmth, discharge or excessive bleeding
R
from the catheter site
KEY POINTS
ain, swelling or a large bruise around the
P
catheter site
• Tubing
Clamp—Make sure clamp is open. Check for tubing
kinks. If tubing appears crimped, massage area to facilitate
flow. Do not break off clamp. Clamp is provided to stop
infusion if necessary (see Patient Monitoring).
Dizziness, light headedness
Blurred vision
• Filter—Do not tape over in-line filter.
Ringing, buzzing in the ears
• Flow
Controller—located at end of pump tubing. Placement
is important for accurate flow rates:
Metal taste in mouth
umbness and/or tingling around mouth, fingers
N
or toes
F ixed Flow – Flow controller should be in contact with
patient’s skin. Tape if necessary.
Drowsiness
N-Q C-bloc with ON-Demand – Controller is inside
O
bolus device. Skin contact is not necessary. Bolus
device should be worn outside of patient’s clothing
and kept at room temperature.
Confusion
• Patient Precautions:
Patient
may experience loss of motor control or feeling
at and around the affected limb. Ensure appropriate
measures are followed to avoid patient injury. Take
care when placing hot or cold items on a numb limb.
N-Q C-bloc with Select-a-Flow – Rate is controlled by
O
the controller. Skin contact is not necessary. Variable
rate controller should be worn outside the patient’s
clothing and kept at room temperature.
• F low controller should not be in contact with cold therapy
pads. Contact with cold therapy decreases flow rate.
INFUSION COMPLETE
•P
atient Discharge—if patient is discharged home with C-bloc,
provide patient with Patient Guidelines.
• Infusion is complete when delivery time has passed and the
C-bloc pump is no longer inflated. A hard tube can be felt in
the middle of pump.
2
•C
atheter Removal—Catheter should
be removed by the physician or
per physician instructions.
CHANGING THE FLOW RATE
•D
ispose of the C-bloc pump in
appropriate manner according to
your institution’s protocol.
• Flow rate is within a predetermined range and is designated
on the device (1–7 or 2–14 ml/hr).
C-BLOC WITH SELECT-A-FLOW ONLY
• Insert rate-changing key into dial and turn dial until new flow
rate is selected. Make sure the selected flow rate is aligned
below the ml/hr ▼ on the Select-A-Flow. The tactile feel will
allow the user to ensure the selected flow rate is set.
Empty pump
PRECAUTIONS
• Do not reuse.
CAUTION: Ensure proper flow rate is dialed. Flow rate is
unpredictable if it is dialed between rate settings.
•P
rotect the pump and catheter site from water according
to physician’s instructions.
To discourage tampering, remove rate changing key from dial
by pulling key straight out. Put key in a safe place for later use
e.g., attached to a key ring. Plastic cover may be locked on
the device using a tie wrap.
LATEX INFORMATION
Latex is not in fluid pathway or in contact with humans.
GIVING A BOLUS
PUMP
C-BLOC WITH ON-DEMAND ONLY
BOLUS
BUTTON
REFILL
INDICATOR
If patients are experiencing
breakthrough pain, they have the
ability to administer a 5 ml bolus:
CLAMP
RATE-CHANGING KEY
FLOW RATE DIAL
FILTER
•P
ress down on bolus button until it
locks into place.
•B
olus will be delivered and
reservoir will start to refill.
LOCKABLE COVER
• Next
full bolus is available when
the button is completely up and
orange indicator is at the top
(in approximately 30 or 60
minutes depending on pump
model).
SELECT-A-FLOW
PRIMING & STARTING INFUSION
Use Aseptic Technique
If ON-Q C-bloc has been refrigerated, allow the pump to reach
room temperature before using.
•P
ressing bolus button before end
of refill time will deliver a partial
bolus dose.
NOTE: Prior to connecting the C-bloc to the patient, verify
that all air has been removed from pump tubing and tubing is
completely primed. If priming is necessary, follow the C-bloc
model specific instructions below:
NOTE: A bolus should be given as soon as possible after
the infusion has started to ensure the bolus device is working
properly. Bolus button should pop back up within a few minutes
and the orange indicator should be at the bottom level.
ON-Q C-BLOC FIXED FLOW RATE
WARNING: If the button does not pop back up within 30
minutes, check position of orange refill indicator:
Priming the Administration Set
1. If indicator is in the lowermost position, close clamp.
If button pops back up within 10 minutes, open clamp and
continue with infusion. If button remains stuck, it may result
in a significant increase in flow rate to patient. Keep clamp
closed. Pump should be replaced if appropriate.
1. Open clamp and remove tubing cap to start priming
2. When all air has been removed from the entire tubing and
fluid flow is observed at end of distal luer the set is primed.
3. Close clamp and replace tubing cap until ready to use.
or
Starting the Infusion
2. If indicator remains in the uppermost position, something
may be impeding the flow. Check for tubing kinks, closed
clamp or patency of connected devices such as catheter
or unvented filter (verify patency) according to your
standard protocol.
1. Connect tubing to patient’s catheter and open clamp to
begin infusion.
2. Tape Flow controller to skin to ensure flow rate accuracy.
3. Open clamp to begin infusion.
3
ON-Q C-BLOC WITH SELECT-A-FLOW
Priming the Administration Set
1. Verify that tubing clamp is closed.
2. Open plastic cover. Ensure dial on face of device is at
highest flow rate setting. Make sure the selected flow rate is
aligned below the ml/hr ▼ on the Select-A-Flow. The tactile
feel will allow the user to ensure the selected flow rate is set.
3. Open clamp and remove distal end cap from tubing.
important to remove red tab completely and ensure it does
not break (Fig C). The bolus device will begin to fill.
6. The pump is now ready to use; however a complete bolus
dose won’t be available until the refill time has elapsed.
The orange indicator will be at the top level (Fig D).
Starting the infusion
1. Connect pump tubing to patient’s catheter. Make sure
connection is secure.
2. Open clamp to begin infusion.
4. When air has been removed and fluid is observed at end of
luer lock, turn the dial to the Ø, off position. Replace distal
end cap until ready to use.
Figure A
Figure B
LAY ON FLAT
SURFACE
Starting the Infusion
This side
up for priming.
Remove red
tab before
use.
1. Connect pump tubing to the patient’s catheter. Make sure
connection is secure.
2. Select appropriate flow rate by turning the dial on the
Select-A-Flow unitl the flow rate setting is aligned with the
ml/hr ▼ mark on the face of the Select-A-Flow. The tactile
feel will allow the user to ensure the selected flow rate is set.
Figure C
Figure D
BOLUS
REFILL
INDICATOR
3. Open clamp to begin infusion.
CAUTION:Ensure proper flow rate is dialed. Flow rate cannot
be predicted if it is dialed between rate settings.
ON-Q C-BLOC WITH SELECT-A-FLOW
& ONDEMAND
Priming the administration set
ON-Q C-BLOC WITH ONDEMAND
Priming the administration set
CAUTION: Do not remove the red tab until the tubing is
completely primed. Up to a 5 ml bolus of air may be delivered
if not primed correctly.
1. Lay ONDEMAND device on flat surface with red tab label
side up (Fig A).
2. Open clamp and remove tubing cap to begin priming.
Do not discard tubing cap.
3. When all air has been removed from the tubing and fluid
is observed at end of luer lock (approximately 4 minutes),
the tubing is primed.
4. Replace tubing cap until ready to use.
5. Remove the red tab by pulling straight out (Fig B). It is
There are two channels to prime. The ONDEMAND is primed
first, followed by the Select-A-Flow.
1. Open the plastic cover of the Select-A-Flow and set dial
to (Ø), off position
2. T o prime the ONDEMAND channel, follow steps (1–3) under
the ON-Q C-bloc with ONDEMAND section.
3. Once the ONDEMAND channel is primed, set dial on the
Select-A-Flow to highest flow rate setting. Follow steps (3–4)
under ON-Q with Select-A-Flow section.
4. To complete the priming process, follow steps (5–6) under
the ON-Q C-bloc with ONDEMAND section.
Starting the Infusion
1. Follow steps (1–3) under ON-Q C-bloc with Select-A-Flow
section at the top of this page.
A K I M B E R L Y- C L A R K H E A L T H C A R E C O M PA N Y
F O R P R O D U C T R E L AT E D I N F O R M AT I O N C A L L
800.448.3569
or
949.206.2700
V I S I T U S AT
myON-Q.com
20202 Windrow Drive | Lake Forest | California 92630
1303734C 04/2011
Rx only.
I-Flow, ON-Q, C-bloc, and Select-A-Flow are registered trademarks of I-Flow Corporation.
Redefining Recovery and ONDEMAND are trademarks of I-Flow Corporation.
There are inherent risks in all medical devices. Please
refer to the product labeling for Indications, Cautions,
Warnings and Contraindications. Failure to follow
the product labeling could directly impact patient
safety. Physician is responsible for prescribing and
administering medications per instructions provided by
the drug manufacturer. Refer to www.myON-Q.com
for product safety Technical Bulletins.

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