INTRODUCING THE ARROW ® ERGOPACK TM SYSTEM Central Venous Catheter Arrow, ARROWg + ard, ARROWg + ard Blue, ARROWg+ard Blue PLUS, AGB+, SharpsAway II, Arrow Advancer, Teleflex and HemoHopper are trademarks or registered trademarks of Teleflex Incorporated or its affiliates. SafetyGlide is a trademark of Becton, Dickinson and Company. Hi-Lite Orange and ChloraPrep are registered trademarks of Cardinal Health Inc. or one of its subsidiaries. ©2010 Teleflex Incorporated. All rights reserved. 2010-0456 v1 J TIP SPRING WIRE GUIDE WITH ARROW ADVANCER™ ❏ .025" diameter x 60 cm length ❏ .032" diameter x 60 cm length INFECTION PROTECTION FEATURES • Sterile Procedure STOP Sign • Central Line Insertion Checklist • Central Line Insertion Practices Adherence Monitoring Form (CLIP Sheet) • 3 mL Hi-Lite Orange ® ChloraPrep ® • Sterile Hand Towel • Maximal Barrier Drape (54" x 96" with a 4" fenestration) • Surgical Cap • Mask with Eye Shield • Surgical Gown • HemoHopper ® Fluid Receptacle SHARPS SAFETY FEATURES • SharpsAway II™ Locking Disposal Cup • 1 inch 25 Gauge SafetyGlide™ Injection Needle • 1-1/2 inch 22 Gauge SafetyGlide Injection Needle • Safety Scalpel OTHER PROCEDURAL ITEMS • 5 mL Lidocaine Ampule • Lidocaine Syringe Label • Gauze Pads {2 (2" x 2" Pads) and 5 (4" x 4" Pads)} • Catheter Over Needle: 18 Gauge x 2-1/2" Catheter with a 20 Gauge RW Introducer Needle • Arrow Raulerson Syringe with Echogenic Introducer Needle: 18 Gauge x 2-1/2" Needle • Green Pressure Transduction Probe • Tissue Dilator • Box Clamp and Fastener • Needle Holder, Curved Needle, and Silk Sutures DATE OF INSERVICE: _____________________________ SURFACE TREATMENT ❏ Antimicrobial ❏ Non-Antimicrobial FRENCH SIZE ❏ 7 ❏ 8 ❏ 8.5 LENGTH ❏ 16 cm ❏ 20 cm NUMBER OF LUMENS ❏ One ❏ Two ❏ Three ❏ Four AFFIX SALES BUSINESS CARD HERE CVC LUMEN 2 CVC LUMEN 3 CVC LUMEN 4 CVC LUMEN 1 21-step insertion checklist CLIP (Central Line Insertion Practices) Adherence Monitoring form; compliant with CDC, IHI, INS and NHSN recommendations EXCLUSIVE: SharpsAway II Locking Disposal Cup Easily and safely move used needles to disposal container Optional ARROWg + ard Blue PLUS ® catheter Chlorhexidine/silver sulfadiazine catheter is a SHEA/IDSA AI recommendation for prevention of catheter-related infection Maximal Barrier Set } Mask with Eye Shield } Surgical Cap } Surgical Gown } Exclusive, easy-to-use head-to-toe drape SHEA/IDSA, CDC1A, IHI and INS recommendations SafetyGlide injection needles Engineered to eliminate the tradeoffs between efficacy and safety Arrow Raulerson Syringe with Echogenic Introducer Needle Enhanced visibility for ultrasound-guided insertions Suture set Curved suture needle and quality stainless steel needle holder Sterile procedure STOP sign Creates awareness of a sterile area during an insertion procedure Safety scalpel Retractable blade for easy-to- control sharps protection EXCLUSIVE: HemoHopper fluids receptacle Conveniently isolates discarded procedural fluids EXCLUSIVE: Hi-Lite Orange ChloraPrep CDC1A, IHI and INS recommendations Lidocaine label Recommended by The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) National Patent Safety Goals Sterile hand towel Supports sterile hand hygiene