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AUTOVAC Technical
Manuals
AUTOVAC FAQ's
AUTOVAC
FAQ's
General
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What is the difference between
a 170 micron filter and the Free Lipid Wick?
The filter and the wick are
similar in that they both remove an undesirable substance from the
blood collected in an Autovac. The 170 micron filter is a screen material
with a pore size of approximately 170 microns. This filter removes
particles that are larger than 170 microns from the blood as it flows
through it. (Note: A red Cell is approximately 8 microns in size.)
This filter is a coarse particulate filter. It is intended to be used
in conjunction with a microaggregate filter with a pore size of 20-40
microns, typically employed in the infusion set.
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Is a Filter in the blood
line necessary?
Yes. Use of microaggregate filter
in the return of Autologous Whole Blood is a common practice.
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How much time do I have to
infuse?
The AABB Standards for Autologous Transfusion, 1st Edition indicates that collection and infusion of shed blood is not to exceed 6 hours.
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Can the Hospital use the
same blood line and filter they are currently using?
We recommend that a microaggregate
filter be used when returning Autologous Whole Blood to a Patient.
As long as the filter has a rating of 20-40 microns, It should be
acceptable.
The infusion line should be
compatible with the filter that the Hospital is using.
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Are AUTOVAC® products
latex free?
Yes, all of our products are
latex free.
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Can I use AUTOVAC® products after the expiration date?
Our sterile packing is labeled with an expiration date of 2 years after packaging. Our testing has shown that the contents of our AUTOVACŪ packaging remain sterile for over one year beyond the date on the package. This excludes packaging that has been broken or punctured in any way. It is important that the user verify for himself the integrity of the package by thorough inspection of all surfaces and joints regardless of the labeled expiration.
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Is there an expiration date on ACD-A?
ACD-A is labeled with a date of expiration. As it is a pharmaceutical, not a sterile product, it should not be used beyond the date of expiration.
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What can I do if I am out of ACD-A or if my stock has expired?
It may be possible to request CPD solution from the pharmacy in the hospital. CPD comes on 500 ml bottles or bags. The dosage is the same as for ACD-A. 40 ml of CPD is equivalent to 40 ml of ACD-A. Additionally, Heparin can be used in place of ACD-A by reconstituting 40,000 IU into a 1 Liter bag of saline for injection. The volume dose for this heparin solution is the same as for ACD-A.
Intraoperative
Systems
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Is ACD-A required for the
Intra-operative System?
We recommend the use of an Anticoagulant
prior to collection of shed blood into an Autovac system. It is imperative
that an Anticoagulant be used prior to the accumulation of blood products
into an Intra-operative System. Even the use of systemic anticoagulation
such as Heparin does not preclude the need to aspirate anticoagulant
into the System.
We are receiving increased requests
for our recommendation on alternates to our 40 ml ACD-A solution for
use in the Autovac Intraop and Postop. The following recommendations
should be used.
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It may be possible to request
CPD solution from the pharmacy in the Hospital. CPD comes in 500
ml bottles or bags. The dosage is the same as for ACD-A. 40 ml.
Of CPD is equivalent to 40 ml of ACD-A.
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Heparin can be used in place
of ACD-A by reconstituting 40,000 IU into a 1 liter bag of saline
for injection. The volume dose for this Heparin solution is the
same as for ACD-A.
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My OR has wall vacuum units,
can I use AUTOVAC IO Model 7904R?
No, we ask that you use 7904
in an environment that has regulated suction.
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Why is AUTOVAC Intraoperative
contraindicated for spinal procedures?
Spinal surgeries typically involve
several factors that allow high volumes of free hemoglobin in the
salvaged blood as a result of damaged or ruptured red blood cells.
Therefore the blood is not of a desired quality to return to the patient.
Cellular damage can result from contact with foreign surface and the
drying of blood under surgical lights. The damaging factors, combined
with surgical site debris make intraoperative salvage with AUTOVAC
IO specifically contraindicated for spinal and other orthopedic procedures.
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I can't seem to get enough
suction on the Intraoperative system. What can I do to remedy this?
When using the Intra-operative
system with integral regulator, Model 7904R, it is important to attach
the vacuum port directly to a source of line suction. The integral
regulator will control the vacuum to a safe level for Autotransfusion.
On non-regulated models, attaching to a wall regulator such as our
model 3700, set to 100 mm Hg. Should provide adequate suction.
Wall outlets need to be verified
periodically that they are meeting JCAHO standards. Boehringer Laboratories
produces instrumentation for verifying wall outlet performance.
The Intra-operative System contains
a membrane shutoff. Care should be taken to keep the Intra-operative
system vertical once collection has begun. Flow through the filter
may become compromised if the unit is allowed to lie on its side.
Post
Operative Systems
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Is ACD-A required for the
Post-operative Orthopedic System?
We recommend the use of an Anticoagulant
prior to collection of shed blood into an AUTOVAC® system. There
is controversy on the use of such Anticoagulant in Post-operative
Orthopedic Systems. It is believed that the blood shed in an Orthopedic
application is defibrinated and therefore unable to clot. This is
evidenced by the fact that many orthopedic drainage cases are clot
free. The process whereby defibrination can take place is complex
and relies upon controlled blood loss. In cases of rapid blood loss,
the complete process of defibrination may not take place and clotting
in the system can occur. Since it is not practical to predict which
cases will occur at a high rate of loss, it is reasonable to recommend
use of a citrate anticoagulant to ensure proper functioning of the
system under all circumstances.
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When can I start infusion
from the AUTOVAC TC?
Infusion can begin as soon as
the minimum volume necessary to obtain an optimal anticoagulant ratio,
typically 300 cc., has been collected. As is the case in all infusion
procedures, it should be at the direction of a Physician.
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A feature of the AUTOVAC
TC is an anti-air embolism valve. Why is this important?
We use an air embolism valve
in the TC because there is a potential source (remote) of air entry
into the bag via the bulb. In the unlikely event that there develops
1) an air leak in the wound drain that 2) goes undetected by the nurse
and 3) he/she continues to pump the bulb until the blood bag blows
up like a balloon and 4) he/she fails to look up and notice that the
blood is rapidly exiting the bag into the infusion line and air is
about to be pumped in, the valve prevents the infusion of air.
The AABB standards require that
hospitals and blood banks use infusion equipment that is designed
to preclude air embolism.
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Can the AUTOVAC TC
be converted to a closed wound drain?
Yes, to convert to passive
wound drain, squeeze the remaining blood from the bulb and clamp off
the line from the bulb to the blood bag. Disconnect bulb from the
line and cap the ends.
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What is the warranty
on the AUTOVAC TC System?
Boehringer warrants that the
AUTOVAC TC product is in compliance with the Standards and Guidelines
applicable to autologous whole blood collected perioperatively as
promulgated in:
Standards for Blood Banks and
Transfusion Services, 16th Edition, American Association of Blood
Banks
Circular of Information for
the Use of Human Blood and Blood Components (AABB OP 1594 ARC1751),
American Association of Blood Banks, American Red Cross, Council of
Community Blood Centers, June 1998.
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There is a new expansion
of the indications for AUTOVAC TC and AUTOVAC 7926. What is it?
The FDA has granted approval
of our request to indicate use of the AUTOVAC TC for salvaging blood
intra-operatively through a surgically implanted drain. The surgeon
may elect to collect salvaged blood during closing after he has implanted
the drain.
This initial blood drainage
can be significant and is otherwise wasted. The AUTOVAC unit travels
easily with the patient for postoperative care.
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