Thank you for tuning in to the HemaClear® Training Center. In this short video we will discuss the proper application of the HemaClear®. Today we will discuss the proper application of the HemaClear® Model A to the ankle.
Once it has been determined that the patient fits within the Model A size guidelines, open the sterile packaging, introducing the sterile Model A to the surgical field. Note that the packaging is dual-peel packed.
Be sure to save the Protective Cutting Card for the end of the procedure. You are now ready to apply the Model A onto the patient.
- Place the patient’s leg flat on the table and place the patient’s toes within the Model A cup, or have your assistant do so.
- Next, the surgeon should hold the handles of the HemaClear® so that one handle is directly over the toes and the other handle is placed over the heel.
- Pulling the handles, advance the Model A to mid foot.
- Next, have one of your team members grab and raise the foot, while applying axial traction.
- Grabbing the handles, advance Model A over the the heel, using the bottom handle as leverage.
- While pulling Model A proximally towards the chest of the patient, advance the ring to just below the calf muscle, approximately 15 cm (6 inches) proximal to the lateral malleolus.
- The tourniquet is now up. Dictate the tourniquet time.
Once HemaClear® has reached the desired occlusion location and the tourniquet time has been recorded, remove the Model A cup exposing your surgical area. To start your procedure simply cut the ribbons off. You are now ready to begin your procedure.
When you would like to remove HemaClear® place the Protective Cutting Card from the distal side of the ring under the HemaClear®. Utilizing a knife, cut the ring in slow orderly passes. Once you’re through the internal silicon ring you can use scissors to remove the rest of the device.
Your 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 (Small, Medium, Large, Extra-Large). Verify that the circumference corresponds to the device range according to the Selection Guide.
For upper extremity procedures, the occlusion location should be 10 cm above the wrist for hand procedures, or mid upper arm (or higher) for forearm, elbow, and distal humerus procedures.
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.
UPPER EXTREMITY: Insert fingertips into the orifice of the device with the handles facing away from the patient (Diagram, Fig. 4). Ensure that all fingers are inserted into the circumference of the ring (Diagram, Fig. 5). Have an assistant stabilize the hand by holding it from the palm side (Diagram, Image top left). Firmly grab the two plastic handles using the colored straps, and pull the handles proximally along the arm to the desired occlusion location (Diagram, Fig. 5).
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 (Pg. 5, 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 (Pg. 5, 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.