Urology & Urogynecology > Education and Reference

PROCEDURAL NOTES

PREPARATION OF MODEL 1880 PRESSURE TRANDUCERS

SUPPLIES:
>> One bag of sterile infusion solution (water or saline)
>> One 1890 Transducer Holder
     - bracketed to IV pole
     - attached to Spectrum case
     - attached to face of patient unit
>> For each pressure being measured (pves, pabd, pura or pcav):
    - One (1) Model # 1880 Interchangeable Pressure Transducer
    - One (1) APIS tubing
    - One (1) sterile 18 Gauge 1" or 2.5cm needle
    - 20 cc syringe Luer lock syringe (optional)

* NOTE: It has been documented that there is mixing of urine with the fluid in the device connected to the bladder cather, whether that device is a tubing (APIS) or the transducer. In addition, devices left sitting moist (transducers, tubings, etc.) quickly become contaminated with environmental flora (e.g., pseudomonas, staph, etc). Therefore, it is recommended that these products be changed between patients. Refer to Application Note: Reuse of Products Labeled "for Single Use only" for additional information.

PROCEDURE:
1. Connect the Model 1880 Interchangeable Pressure Transducer to the Transducer Interface Cable. To connect, align the arrows, and then insert one connector into the other. To disconnect gently pull apart.

2. Insert the transducer (with the vented caps in place) into the 1890 transducer holder.

3. Remove the protective caps from the Luer fittings on the transducer.
4. Remove the protective cap from the female end of the APIS and attach to the male Luer at the top of the transducer.

5. Remove the protective cap from the male end of the APIS tubing and attach a sterile 18G, 1"/2.5 cm disposable needle. Discard the APIS protective cap.

6. Close the two-way stopcock at the base of the 1880 transducer (1880s are packaged with the stopcock open).
7. Spike the needle into the injection port of the solution bag hanging for infusion during CMG. NOTE: Use of an 18 Gauge or larger needle usually facilitates fairly rapid filling of the tubing and transducer from a fluid bag.
8. Open the two-way stopcock to permit the flow of solution from the bag, into the APIS tubing and transducer.

9. As the solution approaches the 1880 transducer
    - Remove the transducer from its bracket and invert it so that the end with the 2-way stopcock is up
    - Gently tap the transducer with the open palm of your hand, to ensure that no air bubbles are in the chamber.
    - NOTE: Do not tap the model 1880 transducer with metal objects (e.g. hemostats) to purge air bubbles.

10. Closely inspect the transducer for presence of air bubbles. If bubbles are detected, repeat steps above.
11. After eliminating all bubbles, close the stopcock and replace the transducer into the holder.

12. Remove the needle from the solution bag injection port and either recap or remove (leaving tip of APIS uncovered).
13. Place the tip of the APIS, (with or without capped needle) behind the superior connection (as shown), at the level of Symphysis Pubis for balancing.
14. The transducer is ready for use.

PROCEDURAL OPTION:
In the event that the tubing and transducer do not fill at an acceptable rate, a 20cc syringe may be used to withdraw the fluid more rapidly. Substitute the following for steps 8 – 14 on the previous pages. NOTE: The syringe that has been used to aspirate solution from a sterile bag, through sterile APIS tubing and an unsterile, reused transducer is considered unsterile and should never be used to:
     - Inject large amounts of solution forward through the transducer, sufficient to reach the distal tip of the APIS tubing and come into contact with the catheter and, therefore, patient’s urine.
     - Flush catheter lumens
8. Attach a sterile 20cc syringe to the female Luer at the base of the 1880 transducer.
9. Open the two-way stopcock and slowly withdraw solution from the bag, into the APIS tubing and transducer.
NOTE: Withdrawing solution too rapidly will create turbulence and increase air bubble formation in the system.
10. When all air has been purged through the transducer and soution has been aspirated into the syringe, close the two-way stopcock.

11. Closely inspect the transducer for presence of air bubbles. If any
are seen:
     - Slide the transducer out of the 1890 holder and invert it, so
that the end with the two-way stopcock and syringe is upright.
     - Gently tap on the transducer with the open palm of your hand, then gently withdraw on the syringe to allow air bubbles to rise and pass through.
     - NOTE: Do not tap the model 1880 transducer with metal objects (e.g. hemostats) to purge air bubbles.

12. Close the stopcock and replace the transducer into the 1890 holder.
13. Remove the syringe from the transducer, injecting the air out, leaving a small amount (~ 2cc) of bubble free irrigating solution.
14. Replace the syringe on the base of the transducer, joining Luer fittings meniscus to meniscus.
15. Remove the needle from the solution bag injection port and either recap or remove (leaving tip of APIS uncovered).

16. Place the tip of the APIS, (with or without capped needle) behind the superior connection (as shown), at the level of Symphysis Pubis for balancing.
17. The transducer is ready for use. NOTE: Do not connect APIS tubing to catheters until syem has been balanced and provides “ready for patient connection” message.