Avanos Medical
CORTRAK 2 Quick Reference Guide
Quick Reference Guide
4 Pages
Preview
Page 1
ONLY USE CORTRAK* 2 IF TRAINED
Contraindications For Use DO NOT use the CORTRAK* 2 Enteral Access System for patients with implanted medical devices that may be affected by electromagnetic fields.
CORTRAK*2 ENTERAL ACCESS SYSTEM QUICK REFERENCE GUIDE WARNING: Failure to follow instructions when setting up CORTRAK* 2 including Receiver Unit (RU) can lead to injuries and/or death. Transmitting Stylet tip position and track displayed on CORTRAK* 2 Monitor is affected by variables including RU positioning on patient, patient size and build, anatomical variances, and movement of RU relative to patient.
WARNING: The CORTRAK* 2 is not intended to replace qualified clinicians in the supervision of feeding tube placements. Only clinicians trained according to Avanos training should use the CORTRAK* 2 . Institution protocols must always supersede the use of the CORTRAK*2 . Clinical judgment must always take precedence.
Screen Views
CORTRAK* 2 Placement Screen Y-axis: Represents patient midline for properly positioned RU (See Set Up Instructions in Step 4)
Rx Only
Supplies
X-axis: Represents diaphragm for properly positioned RU (See Set Up Instructions in Step 4)
• Monitor Unit (MU)
Yellow tracing represents history of Stylet tip movement through body
• CORTRAK* 2 Feeding Tube • Water-soluble lubricant • Water to flush feeding tube and activate hydrophilic lubricant
WARNING: The CORTRAK* 2 Monitor displays a representation of the Transmitting Stylet tip path relative to the RU. This representation is NOT an image of the actual feeding tube position.
Change View
Anterior View
Lateral View
Depth Cross Section
• Receiver Unit (RU) • Syringe • Tape or CORGRIP* (NG/NI tube retention system)
Anterior View
Lateral View
Depth Cross Section
• Transmitting Stylet • Tape or orange weight to secure RU • Towel or leveling device (If needed to level receiver) • Power Cord • Power Supply
WARNING: DO NOT use CORTRAK* 2 with catheters other than Avanos Medical CORFLO* feeding tubes that are compatible with this system. Potential complications with the CORTRAK* 2 are those normally associated with the risks of feeding tube placements (for example, lung intubations and pneumothorax).
SET UP
ONLY USE CORTRAK* 2 IF TRAINED
Positioning and Setup Monitor Position Receiver Unit and Monitor Unit should be at least 2’ apart.
Position Patient Per Institution Protocol.
1
Make Connections and Inspect Receiver Unit to Monitor Unit
Interconnect Cable to Monitor Unit
2
Turn On and Login
3
Turn Monitor on • Press and hold for approximately 5 seconds until it remains green to power on. • Enter your login & password.
Select “New Placement”. Enter patient information (first and last name, ID #).
Place Front Foot of Receiver on Xiphoid Process
Place front foot of Receiver on Xiphoid, align vertically to patient midline and parallel with spine. To level for patient, place a towel under the Receiver.
4
Secure Receiver with tape (directly on skin) or with weight. WARNING: Use extreme caution in patients who are combative or who move excessively during placement as the displayed track is impacted by movement between the receiver unit and the patient. The RU should be secured on the patient.
Palpate lower sternum, follow to Xiphoid.
WARNING: Transmitting stylet must be handled with care at all times and discarded if transmitting wires break.
INSERTION
ONLY USE CORTRAK* 2 IF TRAINED
Tube Preparation Stylet to interconnect cable
5
Secure stylet to tube Connect Stylet cable (orange) to Interconnect Cable (orange) and secure Stylet to tube.
Measure tube per institution protocol.
Lubricate tube.
Initiate Insertion Insert tube + Stylet
If you see OUT OF RANGE, be patient the green dot (representing tube tip) is not in range yet. Slowly advance the tube.
6 For Adult Position tube at 5-10 cm inserted into nasal passage.
For Pediatric Position tube into nare.
Press start on the MU or orange button on RU.. Wait for green light on Receiver to blink.
Insertion
If tube deviates from vertical midline, respiratory irritation or distress occurs, or resistance is met, STOP INSERTION and immediately withdraw tube. Re-assess the patient and notify physician per institution protocol.
Advance tube through esophagus to stomach and small bowel per physician’s order.
7 Stomach
Small Bowel
Continuously observe and assess both the patient and the tracing while advancing the tube to ensure proper insertion of the tube. A green dot on the trace indicates active tip. Red dot indicates placement has ended.
End and Print
8
WARNING: CORTRAK* 2 does not prevent patient injury due to misplacement of feeding tube into the trachea or lungs.
WARNING: Comply with Institution protocol to determine final location of tube tip. Neither CORTRAK* 2 trace nor tube centimeter markings should be used as sole method of confirmation. Clinical observation and institution protocols must be part of successful tube placement.
After desired tube tip position is achieved: • Press end on MU or orange button on RU. • Secure tube and confirm tube placement per institution protocol. • Flush tube to activate internal lubricant. • Disconnect, remove, clean† Stylet and store loosely coiled in WARNING: Tube position must be the bag provided in accordance confirmed per institution protocol with institution protocol. prior to flushing with water. † Refer to Instructions for Use insert packaged with Avanos CORTRAK* 2 Feeding Tube
Print • Press print on main screen. • Switch to 3rd screen view. • Press to print 3rd screen view. • Place print per institution protocol.
OPERATING AND TROUBLESHOOTING TIPS
Solution
Situation
Monitor
Monitor won’t turn on.
Hold for approximately 5 seconds until a solid green light appears.
Transmitting Stylet/Driver Fault message.
Re-connect the Stylet to the Interconnect Cable. Press “Try Again”
Out of Range message.
Transmitting Stylet tip is not in detection range of the RU yet. Slowly advance the tube while continuously observing and assessing both patient and real-time tracing to ensure proper insertion of tube.
Solid green light on Receiver Unit.
Placement tracking not started yet. Press solid orange button and wait for blinking green light to appear before advancing.
Blinking green light on Receiver Unit.
System is ready and will begin to track position of tube. Slowly advance tube.
Blinking red light or Receiver Unit Fault / Receiver Unit Self Test Failure messages
Check to make sure the RU is at least 2 feet from the Monitor Unit. Unplug RU and reconnect to Monitor Unit. If the problem persists, the Receiver may need to be replaced.
Receiver Unit (RU) Tracing makes an abrupt turn or jumps during placement.
Tracing comes from the side not center.
Transmitting Stylet
Track does not follow expected path, out of range message remains or transmitting stylet/driver fault notification appears on MU. Tracing takes a sharp turn to the right or left above the horizontal axis (top quadrants of the screen).
Tube Placement
Tracing is not following the expected path. Green dot does not move forward on Monitor display when advancing tube from stomach into small bowel.
RU moved relative to placement on patient. STOP INSERTION and immediately withdraw tube. Check location of RU for movement. Reposition and resecure front foot of RU on Xiphoid Process. Reinsert tube per instructions. RU not properly positioned on patient. STOP INSERTION and immediately withdraw tube. Reposition and resecure front foot of RU on Xiphoid Process. Reinsert tube per instructions. Damage to transmitting stylet suspected. STOP INSERTION and immediately withdraw tube. Prior to further insertion, check connection and ‘Try Again’ or ‘End’ the placement. Lung placement suspected. STOP INSERTION and immediately withdraw tube. Re-assess the patient and notify physician per institution protocol. STOP INSERTION and immediately withdraw tube. Re-assess the patient and notify physician per institution protocol. Coiling in stomach is suspected – slowly retract the feeding tube until green dot moves backward. Then proceed. Remove Transmitting Stylet, lubricate with water soluable lubricant, attempt insertion again following institution protocol.
Transmitting Stylet Insertion
Transmitting Stylet Removal
Transmitting Stylet does not advance during insertion into feeding tube.
Transmitting Stylet feels stuck or difficult to withdraw during removal.
WARNING: Inserting the transmitting stylet while the tube is indwelling should be performed by a clinician who is qualified by their institution to reposition feeding tubes or to advance them into the jejunum when clinically necessary. NEVER use vigorous force during Transmitting Stylet insertion. NEVER use the Transmitting Stylet to unclog the feeding tube.
To remove the Transmitting Stylet, activate internal lubricant by flushing feeding tube with 10ml of water. WARNING: Tube position must be confirmed per institution protocol prior to flushing with water.
Distributed in the USA by Avanos Medical Sales, LLC, 5405 Windward Parkway, Alpharetta, GA 30004 USA. In USA, 1-844-4AVANOS (1-844-428-2667). www.avanos.com Avanos Medical, Inc., 5405 Windward Parkway, Alpharetta, GA 30004 USA. Avanos Medical Belgium BV, Leonardo da Vincilaan 1, 1930 Zaventem, Belgium. Sponsored in Australia by Avanos Medical Australia Pty Ltd, 475 Victoria Avenue, Chatswood, NSW 2067 Australia. *Registered Trademark or Trademark of Avanos Medical, Inc., or its affiliates. © 2018 AVNS. All rights reserved. 2022-05-18 15-M1-360-02 / 50001143
www.avanos.com