In this short video we will discuss the proper application of the HemaClear®. Today we will discuss the proper application of the HemaClear® Black & White to the lower extremity.
Once the correct size HemaClear® has been determined, open the sterile packaging, introducing the HemaClear® to the sterile field. Note that the HemaClear® is dual peel packed.
Be sure to save the HemaClear® Cutting Card for the end of the procedure. You are now ready to apply HemaClear® onto the patient.
Take note that the patient is prepped very proximally to allow for an increased sterile field and adequate room for the HemaClear® tourniquet.
- To apply the HemaClear® place the patient’s leg flat on the table.
- Next, the HemaClear® should be placed so that one handle is placed directly over the toes and one handle is over the heel. Pulling the handles that are north and south advance the HemaClear® to mid foot. Next, have one of your team members grab and raise the foot while applying axial traction.
- Grabbing 2 handles per each person advances HemaClear® over the heel. Utilize the bottom handle as leverage to advance the HemaClear® over the heel. It does not matter which color handle each person grabs.
- While pulling HemaClear® proximally towards the chest of the patient, advance the ring.
- To advance the HemaClear® wrap the straps around your hands. This will keep the straps within the sterile field and provide more leverage. It is helpful if team members supporting the foot, apply axial traction while vertically lifting the leg during application.
- Pulling proximally, advance the HemaClear® to the proximal thigh.
- Note the proximal placement of the HemaClear®. It is imperative to place the HemaClear® as high as possible on the thigh to ensure proper occlusion of the femural artery.
The tourniquet is now up. Dictate the tourniquet time.
Once the HemaClear® has reached the desired occlusion location and tourniquet time has been recorded, wrap the straps distal to the HemaClear® ring. This is especially helpful to prevent roll-back in patients with conic shaped thighs. If roll-back is not a concern, simply cut the straps.
Expose the surgical field and begin the procedure.
When you would like to remove the HemaClear® place the Cutting Card from the distal side of the ring under the HemaClear®. Utililzing a knife cut the ring with slow orderly passes. Once you are through the silicone ring use scissors to remove the rest of the device.
The tourniquet is now down. Note the tourniquet time.
Thank you for tuning in to this HemaClear® training segment. If you have any further questions please contact us or ask your local Product Specialist.
How to Use the HemaClear® Pressure Tables
HemaClear® Model A™ for Foot & Ankle Surgery
Applying HemaClear® Model A Step 2: Assistant holds the foot while ModelA is pulled towards the heel using straps
Directions for Use
Measure the limb circumference at the occlusion location using the Measuring Tape provided, which is color coded according to circumference, in order to select the correct HemaClear® Model Extra-Large. Verify that the circumference corresponds to the device range according to the Selection Guide.
For lower extremity procedures, the occlusion location should be 5-15 cm above the lateral mallelous (below the calf muscles) for foot procedures, or mid or upper thigh for ankle, lower leg, knee, or distal femur procedures.
Measure the distance from the tips of the fingers/toes to the occlusion location. Verify that the distance does not exceed the device maximal length according to the Selection Guide.
Verify that the patient’s systolic blood pressure does not exceed the limit specified in the Selection Guide for the selected HemaClear® Model.
Refer to the appropriate color coded Pressure Table for device pressure at skin level.
Using a sterile technique, open the outer envelope of the device and drop it onto the sterile field, with inner envelope intact. Use a sterile technique to remove the device from within the inner envelope.
Keep the Protective Cutting Card for the end of the procedure to protect the skin when the silicone ring is cut, in keeping with instructions regarding use of the Protective Cutting Card.
If the patient is awake, explain the application procedure and warn about possible ring pressure discomfort. Sedation and/or analgesia may be used. Disinfect the limb according to the type of procedure performed. Apply sterile drapes so that they overlap the edge of the disinfected region.
LOWER EXTREMITY: Insert the toes into the orifice of the device with the handles facing away from the patient. Ensure that all the toes are inserted into the circumference of the ring. Position the device on the toes so that one handle is aligned with the bottom (sole) of the foot, and the other handle is aligned with the top of the foot (Diagram, Fig. 4). Stand proximally to the patient’s foot, so that when pulling the device straps proximally on the patient’s leg, you are pulling towards your body. Have an assistant stabilize the foot and ankle fo the patient (Diagram, Image top right). Firmly grab the two plastic handles using the colored straps, and pull the handles first along the foot and then proximally along the leg. To roll HemaClear® over the heel, apply more force to the bottom handle, using it as a hinge. Once over the heel, continue pulling on the handles until HemaClear® reaches the desired occlusion location (Diagram, Fig. 5).
Occlusion locations: A) On the calf (5-15 cm above the medial mallelous, below the calf muscle) or B) On the thigh (at or above the mid-thigh).
NOTE: HemaClear® should be placed within the sterile field on the limb over the edge of the sterile drapes.
Once HemaClear® is in place, the colored straps can either be wrapped around the limb, distal to the HemaClear® ring, or cut off (Diagram, Fig. 6).
Expose the incision site by pulling the stockinet up, removing it, or cutting a window in the fabric (Diagram, Fig. 7).
NOTE: To minimize lint, dampen the fabric with sterile water or saline before cutting it.
Tourniquet Time begins as soon as the HemaClear® is in place. Tourniquet Time ends when the HemaClear® is removed (Diagram, Fig. 8).
When the procedure is over, insert the Protective Card under the ring from its distal side by pulling one of the straps and cut the ring with a scalpel. Use scissors to cut and remove the remaining stockinet. Blood flow to the limb will resume.