Rapidly insertable central catheters including catheter assemblies and methods thereof
Rapidly insertable central catheters (“RICCs”) including catheter assemblies and methods thereof reduce both steps and medical devices involved in introducing a catheter. A RICC assembly can include a RICC, an introducer, and a coupling system coupling the RICC and the introducer together. A catheter tube of the RICC can include a side aperture in a distal-end portion of the catheter tube, which opens into an introducing lumen extending from the side aperture to a distal end of the RICC. The introducer can include an introducer needle having a cannula. The coupling system can include a distal coupler slidably attached to the catheter tube. The cannula can extend through a longitudinal through hole of the distal coupler, through the side aperture of the catheter tube, along the introducing lumen of the catheter tube, and through the distal end of the RICC when the RICC assembly is in a ready-to-deploy state thereof.
1 . A rapidly insertable central catheter (“RICC”) assembly, comprising:
a RICC including:
a catheter tube including a side aperture through a side of the catheter tube in a distal-end portion thereof, the side aperture opening into an introducing lumen of the catheter tube that extends from at least the side aperture to a distal end of the RICC;
a catheter hub coupled to a proximal-end portion of the catheter tube; and
one or more extension legs, each extension leg of the one or more extension legs coupled to the catheter hub by a distal-end portion thereof;
an introducer including an introducer needle having a needle hub and a cannula; and
a coupling system including a distal coupler slidably attached to the catheter tube proximal of the side aperture; the cannula extending from the needle hub through a longitudinal through hole of the distal coupler, through the side aperture of the catheter tube, along the introducing lumen of the catheter tube, and through the distal end of the RICC when the RICC assembly is in a ready-to-deploy state thereof, the distal coupler including a tab configured to allow a clinician to single handedly advance the RICC off the cannula with a flick-type motion of a single finger of a hand while holding the introducer between a thumb and another finger or fingers of the hand, the RICC assembly thereby providing a mechanism for advancing the RICC without touching the catheter tube.
2 . The RICC assembly of claim 1 , wherein the cannula of the introducer needle extends at least about 2-7 cm from the distal end of the RICC in the ready-to-deploy state of the RICC for a venipuncture with the cannula.
3 . The RICC assembly of claim 1 , the introducer further including:
a guidewire conduit coupled to the needle hub of the introducer needle; and
an access guidewire disposed in the guidewire conduit, the guidewire conduit configured to maintain sterility of the access guidewire.
4 . The RICC assembly of claim 3 , wherein the guidewire conduit includes a longitudinal slit and the access guidewire includes a handle coupled to a proximal-end portion of the access guidewire, the handle protruding through the longitudinal slit for grasping the handle and advancing the access guidewire through the distal end of the RICC without directly touching the access guidewire.
5 . The RICC assembly of claim 4 , wherein the longitudinal slit includes closed ends configured to provide stops for the handle that prevent loss of the access guidewire in a blood-vessel lumen of a patient by over advancement of the access guidewire or withdrawal of the access guidewire from the guidewire conduit by over withdrawal of the access guidewire.
6 . The RICC assembly of claim 3 , the introducer further including a fluid-pressure indicator extending from a side arm of the needle hub, the fluid-pressure indicator fluidly coupled to a needle lumen of the introducer needle by way of a side-arm lumen of the side arm for observing blood flashback.
7 . The RICC assembly of claim 3 , the coupling system further including a proximal coupler removably attached to the catheter hub and slidably attached to the guidewire conduit, the coupling system configured to couple the RICC and the introducer together by corresponding proximal-end and distal-end portions thereof in the ready-to-deploy state of the RICC assembly while allowing the introducer to slide relative to the RICC.
8 . The RICC assembly of claim 7 , wherein the proximal coupler includes sloped sides configured to push the guidewire conduit out of the proximal coupler when a proximal coupler-interacting portion of the introducer interacts with the sloped sides while the cannula is withdrawn from the side aperture of the catheter tube.
9 . The RICC assembly of claim 7 , wherein the proximal coupler includes posts and the catheter hub includes a suture wing with suture-wing holes, the posts disposed in the suture-wing holes in the ready-to-deploy state of the RICC assembly.
10 . The RICC assembly of claim 7 , the RICC further including a sterile barrier over the catheter tube between the proximal coupler and the distal coupler to which couplers the sterile barrier is coupled, the sterile barrier configured to split apart when the proximal coupler is removed from the catheter hub and the sterile barrier is pulled away from the catheter tube.
11 . The RICC assembly of claim 10 , wherein the sterile barrier has sufficient tensile strength to pull the distal coupler off the catheter tube without breaking the sterile barrier when the sterile barrier splits down to the distal coupler while being pulled away from the catheter tube.
12 . The RICC assembly of claim 1 , wherein the RICC includes a set of three lumens including a distal lumen, a medial lumen, and a proximal lumen, each lumen of the set of three lumens is formed of fluidly connected portions of a catheter-tube lumen, a hub lumen, and an extension-leg lumen, the introducing lumen of the catheter tube coincident with a distal-end portion of the distal lumen.
13 . The RICC assembly of claim 12 , wherein the distal lumen has a distal-lumen aperture in the distal end of the RICC, the medial lumen has a medial-lumen aperture in the side of the catheter tube distal of the side aperture, and the proximal lumen has a proximal-lumen aperture in the side of the catheter tube distal of the side aperture but proximal of the medial-lumen aperture.
14 . A rapidly insertable central catheter (“RICC”) assembly, comprising:
a RICC including a catheter tube having a side aperture through a side of the catheter tube in a distal-end portion thereof, the side aperture opening into an introducing lumen of the catheter tube that extends from at least the side aperture to a distal end of the RICC;
an introducer including an introducer needle having a needle hub and a cannula; and
a coupling system including a distal coupler slidably attached to the catheter tube proximal of the side aperture; the cannula extending from the needle hub through a longitudinal through hole of the distal coupler, through the side aperture of the catheter tube, along the introducing lumen of the catheter tube, and through the distal end of the RICC in a ready-to-deploy state thereof, and the distal coupler slidably attached to the catheter tube proximal of the cannula through the side aperture of the catheter tube, the distal coupler allowing a clinician to advance the RICC off the cannula without touching the catheter tube.
15 . The RICC assembly of claim 14 , the introducer further including:
a guidewire conduit coupled to the needle hub of the introducer needle; and
an access guidewire disposed in the guidewire conduit, the guidewire conduit configured to maintain sterility of the access guidewire.
16 . The RICC assembly of claim 15 , wherein the guidewire conduit includes a longitudinal slit and the access guidewire includes a handle coupled to a proximal-end portion of the access guidewire, the handle protruding through the longitudinal slit for grasping the handle and advancing the access guidewire through the distal end of the RICC without directly touching the access guidewire.
17 . The RICC assembly of claim 16 , wherein the longitudinal slit includes closed ends configured to provide stops for the handle that prevent loss of the access guidewire in a blood-vessel lumen of a patient by over advancement of the access guidewire or withdrawal of the access guidewire from the guidewire conduit by over withdrawal of the access guidewire.
18 . The RICC assembly of claim 15 , the introducer further including a fluid-pressure indicator extending from a side arm of the needle hub, the fluid-pressure indicator fluidly coupled to a needle lumen of the introducer needle by way of a side-arm lumen of the side arm for observing blood flashback.
19 . The RICC assembly of claim 15 , the coupling system further including a proximal coupler removably attached to a catheter hub of the RICC and slidably attached to the guidewire conduit, the coupling system configured to couple the RICC and the introducer together by corresponding proximal-end and distal-end portions thereof in the ready-to-deploy state of the RICC assembly while allowing the introducer to slide relative to the RICC.
20 . The RICC assembly of claim 19 , wherein the proximal coupler includes sloped sides configured to push the guidewire conduit out of the proximal coupler when a proximal coupler-interacting portion of the introducer interacts with the sloped sides while the cannula is withdrawn from the side aperture of the catheter tube.
21 . The RICC assembly of claim 19 , wherein the proximal coupler includes posts and the catheter hub includes a suture wing with suture-wing holes, the posts disposed in the suture-wing holes in the ready-to-deploy state of the RICC assembly.
22 . The RICC assembly of claim 19 , the RICC further including a sterile barrier over the catheter tube between the proximal coupler and the distal coupler to which couplers the sterile barrier is coupled, the sterile barrier configured to split apart when the proximal coupler is removed from the catheter hub and the sterile barrier is pulled away from the catheter tube.
23 . The RICC assembly of claim 22 , wherein the sterile barrier has sufficient tensile strength to pull the distal coupler off the catheter tube without breaking the sterile barrier when the sterile barrier splits down to the distal coupler while being pulled away from the catheter tube.
24 . The RICC assembly of claim 14 , wherein the RICC includes a set of three lumens including a distal lumen, a medial lumen, and a proximal lumen, the distal lumen having a distal-lumen aperture in the distal end of the RICC, the medial lumen having a medial-lumen aperture in the side of the catheter tube distal of the side aperture, and the proximal lumen having a proximal-lumen aperture in the side of the catheter tube distal of the side aperture but proximal of the medial-lumen aperture.