Rapidly insertable central catheters, introducers, insertion devices including combinations and methods thereof
Rapidly insertable central catheters (“RICCs”), introducers, and insertion devices including combinations and methods thereof are disclosed. For example, a RICC system can include an introducer and a RICC insertion assembly including a RICC assembly disposed in a RICC insertion device. The RICC assembly can include a RICC, an access guidewire, and a splittable casing over a catheter tube of the RICC and the access guidewire forming a longitudinal composite. The RICC insertion device can include a frame and a nose cover forming a split channel that splits away from a through channel of a nose of the frame. The RICC insertion device can be configured for advancing the RICC assembly by rolling the longitudinal composite across roller wheels disposed in the frame. The through channel can be configured for advancing the catheter tube therethrough while the split channel can be configured for both splitting and passing the splittable casing therethrough.
1. A rapidly insertable central catheter (“RICC”) insertion system, comprising:
a RICC assembly including:
a RICC including:
a catheter tube;
a catheter hub coupled to a proximal 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 portion thereof;
an access guidewire disposed in a primary lumen of the RICC; and
a keeper including a splittable casing over both the catheter tube and a distal portion of the access guidewire extending from a distal end of the RICC forming a longitudinal composite thereof;
a RICC insertion device including:
a frame including:
a longitudinal handle including a wheel well;
a nose extending from a distal portion of the longitudinal handle, distal of the wheel well, the nose including a through channel configured for advancing the catheter tube of the RICC therethrough; and
a curved cradle extending from a proximal portion of the longitudinal handle;
one or more roller wheels disposed in the wheel well; and
a nose cover over the nose, the nose cover and the nose forming a split channel configured for both splitting and passing the splittable casing therethrough, the RICC insertion device configured for advancing the RICC assembly from an initial position in the frame to a final position in the frame by repeatedly pushing the longitudinal composite into the one or more roller wheels and rolling the longitudinal composite across the one or more roller wheels; and
an introducer.
2. The RICC insertion system of claim 1 , wherein the keeper further includes a catheter-hub holder to which a proximal end of the splittable casing is attached, the catheter-hub holder configured to hold the catheter hub therein and keep the splittable casing in position over the catheter tube and the access guidewire.
3. The RICC insertion system of claim 2 , wherein the catheter-hub holder includes a perimetrical wall around at least a portion of a perimeter of the catheter-hub holder, the perimetrical wall defining a recess into which the catheter hub fits with an engineering fit.
4. The RICC insertion system of claim 1 , wherein the curved cradle includes a curved extension over a distal portion of the curved cradle, the curved extension following a same curve as the curved cradle.
5. The RICC insertion system of claim 4 , wherein the curved cradle includes an enclosure over the distal portion of the curved cradle with the curved extension extending therefrom, the enclosure configured to enclose therein an otherwise exposed proximal portion of the access guidewire in the initial position of the RICC assembly in the frame.
6. The RICC insertion system of claim 4 , further comprising a retaining clip configured to clip on to a proximal portion of the RICC, retain the RICC assembly in the RICC insertion device, and keep the catheter tube from prematurely advancing over the access guidewire, the retaining clip including a post configured to engage with a slot in the curved extension that faces an open face of the curved cradle.
7. The RICC insertion system of claim 6 , wherein the retaining clip is configured to disengage with the slot in the curved extension when any remaining slack of the longitudinal composite is removed upon advancing the RICC assembly from the initial position to the final position in the frame.
8. The RICC insertion system of claim 1 , the frame further including a retaining arch over the curved cradle proximate the proximal portion of the longitudinal handle from which the curved cradle extends, the retaining arch configured to retain the RICC assembly in the RICC insertion device and hold the longitudinal composite over the longitudinal handle as the RICC assembly transitions over the proximal portion of the longitudinal handle from which the curved cradle extends upon advancing the RICC assembly from the initial position to the final position in the frame.
9. The RICC insertion system of claim 1 , wherein the nose cover and the nose further form a retaining clamp configured to slidably clamp the longitudinal composite therein, the nose cover rotatable over the nose, and the nose cover including a longitudinal gap configured to rotatably align with the through channel in the nose for removal of the longitudinal composite, the splittable casing, or the catheter tube therefrom.
10. The RICC insertion system of claim 1 , further comprising a retractable nicking blade, the retractable nicking blade disposed in a nicking-blade carriage slidably integrated into the nose, the nicking-blade carriage having a nicking position with the retractable nicking blade extending beyond a distal end of the nose and a safety position with the retractable nicking blade short of the distal end of the nose.
11. The RICC insertion system of claim 1 , the introducer including:
an introducer needle including:
a needle shaft including a needle tip in a distal portion of the needle shaft; and
a needle hub coupled to a proximal portion of the needle shaft; and
a splittable introducer sheath configured to accept therein the introducer needle,
the splittable introducer sheath including:
a splittable sheath body; and
a splittable sheath hub coupled to a proximal portion of the splittable sheath body, the splittable sheath hub including a pair of outwardly extending wings along a length of the splittable sheath hub having an internal angle of about 90° or less between the outwardly extending wings configured for splitting the splittable sheath hub by pinching the outwardly extending wings together with a single hand.
12. The RICC insertion system of claim 11 , wherein the splittable sheath hub includes a single longitudinal fault along a side of the splittable sheath hub opposite a vertex of the internal angle formed by the outwardly extending wings, the splittable sheath hub configured to split along the single longitudinal fault for propagation along a same side of the splittable sheath body when the outwardly extending wings are pinched together.
13. The RICC insertion system of claim 11 , wherein the splittable sheath hub includes a pair of longitudinal faults including a primary fault along a primary side of the splittable sheath hub opposite a vertex of the internal angle formed by the outwardly extending wings and a secondary fault along a secondary side of the splittable sheath hub opposite the primary fault, the splittable sheath hub configured to split along the primary fault for propagation along the primary side of the splittable sheath body when the outwardly extending wings are pinched together, and the splittable sheath hub configured to split along the secondary fault for propagation along the secondary side of the splittable sheath body when the outwardly extending wings are pulled apart.
14. The RICC insertion system of claim 11 , the splittable sheath hub further including a valved cap disposed in a proximal portion of the splittable sheath hub, the valved cap including a tapered female valved-cap connector and a septum, distal of a proximal opening in the tapered female valved-cap connector, the tapered female valved-cap connector configured to accept therein a tapered male needle-hub connector extending from a distal portion of the needle hub, and the septum configured to accept therethrough the needle shaft.
15. The RICC insertion system of claim 14 , wherein the valved cap is partially or fully split such that the valved cap splits with the splittable sheath hub when the outwardly extending wings are pinched together.
16. The RICC insertion system of claim 11 , the splittable sheath hub further including:
an overmolded nicking blade distally extending from the splittable sheath hub; and
a hinged nicking-blade cover having an opened state with the hinged nicking-blade cover opened away from the overmolded nicking blade and a closed state with the hinged nicking-blade cover closed over the overmolded nicking blade.
17. The RICC insertion system of claim 11 , further comprising a syringe including a tapered male syringe tip extending from a distal portion of the syringe, the tapered male syringe tip configured to insert into a tapered female needle-hub connector in a proximal portion of the needle hub.
18. A rapidly insertable central catheter (“RICC”) insertion assembly, comprising:
a RICC assembly including:
a RICC including:
a catheter tube;
a catheter hub coupled to a proximal 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 portion thereof;
an access guidewire disposed in a primary lumen of the RICC; and
a keeper including a splittable casing over both the catheter tube and a distal portion of the access guidewire extending from a distal end of the RICC forming a longitudinal composite thereof; and
a RICC insertion device including:
a frame including:
a longitudinal handle including a wheel well;
a nose extending from a distal portion of the longitudinal handle, distal of the wheel well, the nose including a through channel configured for advancing the catheter tube of the RICC therethrough; and
a curved cradle extending from a proximal portion of the longitudinal handle;
one or more roller wheels disposed in the wheel well; and
a nose cover over the nose, the nose cover and the nose forming a split channel configured for both splitting and passing the splittable casing therethrough, the RICC insertion device is configured for advancing the RICC assembly from an initial position in the frame to a final position in the frame by repeatedly pushing the longitudinal composite into the one or more roller wheels and rolling the longitudinal composite across the one or more roller wheels.
19. The RICC insertion assembly of claim 18 , wherein a distal end of the longitudinal composite, the splittable casing, or the access guidewire is commensurate with a distal end of the frame in the initial position of the RICC assembly in the frame.
20. The RICC insertion assembly of claim 18 , wherein a slack loop of the longitudinal composite extends away from both the longitudinal handle and the curved cradle in the initial position of the RICC assembly in the frame.
21. The RICC insertion assembly of claim 18 , wherein the longitudinal composite is split in the final position of the RICC assembly in the frame.
22. The RICC insertion assembly of claim 18 , wherein a proximal end of an extension leg or a Luer connector coupled to the extension leg of the one or more extension legs of the RICC is commensurate with a proximal end of the curved cradle in the initial position of the RICC assembly in the frame.
23. The RICC insertion assembly of claim 22 , wherein a proximal end of the access guidewire is coupled to the proximal end of the curved cradle in the initial position of the RICC assembly in the frame.
24. The RICC insertion assembly of claim 22 , wherein the one or more extension legs of the RICC lie over the longitudinal handle in the final position of the RICC assembly in the frame.
25. The RICC insertion assembly of claim 18 , wherein the catheter hub of the RICC lies over the wheel well in the final position of the RICC assembly in the frame.