Medrad Stellant D Operation Manual

LSUHSC Shreveport
Radiology Department
Proc 13.17

Operating Guidelines for the Medrad Stellant D Injector

Purpose: In order to minimize extravasations and maintain imaging quality the

following guidelines and instructions shall be used.

Guidelines:

1. Use a 20 gauge or larger IV catheter over needle (a 22 gauge may be used

with slower flow rates).

2. The preferred location for venipuncture is the medially located antecubital

vein.

3. Have at least ½ inch of the catheter positioned in a good vein with rapid

backflow.

4. Use a 60-96 inch coiled low pressure tube securely attached to the

catheter. The coiled tubing reduces motion effect during table
incrementation.

5. Instruct the patient to communicate immediately any pain or change in

feeling during the injection.

6. If possible, instruct the patient to put his or her arm vertically above the

shoulder with the palm of the hand on the ace of the gantry during
injection. This allows for uninterrupted passage of injected contrast
through the axillary and subclavian veins at the thoracic outlet.

7. A small volume test injection of contrast or saline may be utilized to

confirm venous assess. A trained professional should remain by the
patient during the initial stages of the injection palpating the venous access
site to ensure proper placement of the I.V. catheter. If focal pain, swelling
or signs of extravasation are noted, the injection should be stopped
immediately.

8. Central lines and hep-locks should only be used in accordance with

hospital policy guidelines.

9. Adhere to all instructions, warnings, and cautions listed for the specific

products being used.

Injector Operation

DISPLAY CONTROL PANEL

1. INJECTION PHASES: First phase can be Test Inject, Contrast, or

Saline. Test Inject parameters are programmable in the SETUP
SCREEN. Six phases are available for programming. If more phases are
required, press the triangle below the first phase, and Select Contrast A,
Flush B, Hold, or Pause.

LSUHSC Shreveport
Radiology Department
Proc 13.17

2. Flow Rate – 0.1 to 10 ml/sec, Volume – 1 to 20 ml, Pressure Limit – 50

to 325 PSI- Press SET to program.

3. DELAY- programmable to 1 to 99 seconds. Press SET to program.

Emits 5 beeps when delay is complete: Scan Delay, Inject Delay, No
Delay

4. Programmed Volume and Total Duration is displayed on the screen.

5. Syringe icons indicate volume remaining in the syringes. A=Contrast

- green, B+Saline-blue.

6. Press PROTOCOL LOCK on screen.

7. PROTOCOL LOCK must be ON to ARM from the injector head.

SYRINGE INSTALLATION AND LOADING

1. Place the injector head in an upright position with the pistons fully

retracted.

2. Syringes are sterile and for single use only. Patient injury can result

from leaks or ruptures during an injection. Use only MEDRAD
disposable products, or use catheters and connectors with pressure
ratings that are compatible with this system. Inspect syringe packaging

for expiration date and package integrity. Install syringes by inserting
quickly and firmly in one motion. Installing the syringe slowly can result
in an error message. Piston will automatically advance to the front of the
syringe.

SETUP:

1. Using sterile technique, attach the sterile loading device and load the

syringes by pressing AUTOLOAD and FILL A and/or FILL B within 10
seconds. The syringe will load the volume programmed at the Main
Screen.

2. Increase or decrease the volume by pressing the +/- key.

3. Manually load the syringe by pressing MOVE PISTON to activate the

forward and reverse load strips.

4. Expel any air from the syringes using the manual knobs or load strips.

5. Attach LPT with PRIME TUBE attached to the patient end of the tubing.

6. Select PRIME to fill the LPT with contrast or saline – configurable in the

SETUP SCREEN or use manual knobs or load strips.

7. Patient injury can result from high contrast temperature. Do not use the

syringe heat maintainer if the fault indicator light is on.

8. It is recommended that contrast be stored in a heater at 35° C before

loading it in a syringe. Once contrast is loaded, snap the heat maintainer
over the syringe to maintain contrast temperature.

9. Inspect the syringe, tubing, and FluiDots, confirming that all air is

expelled, remove PRIME TUBE, turn injector head down, and connect
LPT to patient ensuring an air-free connection.

LSUHSC Shreveport
Radiology Department
Proc 13.17

10. FluitDots: View looking through the syringe jacket at a light source.



Empty syringe – dots appear as narrow elipses







Full syringe – dots appear larger and almost round.





11. Air embolism can cause death or serious injury to the patient.

Patient injury could result from high flow-rate venous injections.
Patient injury could result from inadvertent aspiration.

Extravasation can cause injury to the patient. Acknowledge that air

inspection has occurred by pressing CHECK FOR AIR. If CHECK FOR
AIR is not pressed at the injector head, the system will request
confirmation that all air was expelled as part of the arming procedure.

INJECTION PROCEDURE

1. Press ARM on the injector head or the Main Screen.

2. Ensure there is sufficient volume to complete the protocol, insufficient

volume is indicated with a message at the Display Console or flashing
indication at the injector head.

3. Press ARM twice at the injector head to proceed with the remaining

volume.

4. Armed Indication Lights – Contrast =green, Saline=blue, will flash when

the injector is armed or on hold and will be solid when injecting.

5. Initiate the injection at the patient side.

6. Injection View – configurable at the Set-Up screen. Volume Remaining

decrements and Delivered Volume increments.

7. Phase – as the phase is activated, it is highlighted, elapsed time and

current

8. Phase is in status window.

9. Pressure Graph – displays the syringe pressure developed during an

injection.

10. ABORT: Press any button on the head or display except

START/HOLD. Pressing START/HOLD during an injection will hold
an injection up to 20 minutes.

11. Injection Complete – summary of parameters selected and delivered are

shown. Elapsed time will continue until

OK is pressed.

12. Syringe Removal – twist syringe counterclockwise with tubing connected

and discard following local guidelines. The piston will automatically
retract.

STORE/RECALL/DELETE

1. STORE- enter desired parameters, press STORE. Title the protocol

using keypad, press ENTER. 32 protocols can be stored in memory.

2. RECALL – press RECALL, press protocol title, press OK.

3. DELETE- press RECALL, press protocol title, press DELETE.