This device consists of a rigid tripod Base, and four Inserts:

For Normal Catheters use inserts

• “Large” for French 10 (3.25mm)
• “Medium” for French 8 (2.70 mm)
• “Small” for French 7  (2.60 mm)
• “Slotted” Insert  (3.25 mm)

For Unitized Catheters only use

• “Slotted” Insert  (3.25 mm)

The inner diameter of the Insert is marked on the insert flange of all inserts.

The slotted insert is for use with a ventricular introducer, a catheter with an incorporated stylet or any other style of unitized catheter.  THE GHAJAR GUIDE® is packaged sterile, with the “Large” Insert assembled in the Base.

Assembly, Loading and Placement Instructions for THE GHAJAR GUIDE® and Normal Catheters:

The following instructions are provided as a general guideline for the use of the device.  The physician, at his or her discretion, may alter the procedure in accordance with medical judgment and clinical experience.

Note:

Normal catheters can be used with any insert of THE GHAJAR GUIDE® Five Piece.

Unitized catheters can only be used with the “slotted” insert of THE GHAJAR GUIDE® Five Piece.

Assembly of THE GHAJAR GUIDE® Five Piece (#05-0002) for Normal Catheters:

The GHAJAR GUIDE® Five Piece should be assembled before loading the catheter. To insure proper fit the catheter and the insert must be matched correctly. Place the appropriate diameter insert into the tripod base. Positioning the insert with the short end in the tripod base or, if a shorter height is required, flip the insert around and place the long end of the insert in the tripod base.  In either case make sure the insert fits into the tripod base firmly and the small knob on the tripod base fits into the square cutout on the insert.

Loading Normal Catheters:

With stylet in place, insert a normal catheter through proximal lumen of the Assembled GHAJAR GUIDE® Five Piece.  The guide and catheter are now ready for use on the cranium. (Figure 2)

Suggested Instructions for Normal Catheter Placement:

Make a burr or twist drill hole in the mid-pupillary line, slightly anterior to the coronal suture. In adults this usually measures 10 cm above the nasion and 3 cm lateral to the midline; for ventricular shift, a move lateral to the midline placement (i.e. 4 cm) on the side of the ventricular shift may be needed.

Following dural puncture, hold the guide with the catheter firmly against the skull or scalp above the cranial hole. (Figure 3a)

With the free hand, manually advance the catheter into the ventricle.

The intracerebral catheter length will vary for different size craniums. (In the normal adult the optimal length is 5cm.)

Grasp the catheter through the base of the guide with forceps to prevent inadvertent movement.

Holding the catheter in place with the forceps, remove the guide and stylet with one motion. Test for cerebrospinal fluid (CSF) manometrics. (Figure 4b)

Assembly, Loading and Placement instructions for THE GHAJAR GUIDE® and Unitized Catheters:

The following instructions are provided as a general guideline for the use of the device.  The physician, at his or her discretion, may alter the procedure in accordance with medical judgment and clinical experience.

Note:
Unitized catheters - catheters with attachments-can only be used with the “slotted” insert of THE GHAJAR GUIDE® – Five Piece (Cat# 05-0002).

Assembly of THE GHAJAR GUIDE® – Five Piece (#05-0002) for Unitized Catheters

The device should be assembled before loading the catheter. Place the slotted insert into the tripod base. Positioning the insert as shown in Figure 4a with the short end in the tripod base or, if a shorter overall height is required, flip the insert around and place the long end of the insert in the tripod base as shown in Figure 4b.  In either case make sure the insert fits into the tripod base firmly and the small knob on the tripod base fits into the square cutout on the insert.

Loading a Unitized Catheter:

With stylet in place, insert a unitized catheter through proximal lumen of THE GHAJAR GUIDE® Five Piece with a slotted insert. The insert may be placed in the tripod base in either direction to facilitate as shown in Figures 5a and b.  The guide and catheter are now ready for use on the cranium. (Figure 5)

Suggested Instructions for Unitized Catheter Placement:

Make a burr or twist drill hole in the mid-pupillary line, slightly anterior to the coronal suture. In adults this usually measures 10 cm above the nasion and 3 cm lateral to the midline; for ventricular shift, a move lateral to the midline placement (i.e. about 4 cm) on the side of the ventricular shift may be needed.

Following dural puncture, hold the guide with the catheter firmly against the skull or scalp above the cranial hole.(Figure 6)

With the free hand, manually advance the catheter into the ventricle.

The intracerebral catheter length will vary for different size craniums. (In the normal adult the optimal length is 5cm.)

Grasp the catheter through the base of guide with forceps to prevent inadvertent movement.

Holding the catheter in place with the forceps, disengage the guide from the catheter by slipping it off the side of the catheter or introducer.

Remove the stylet or ventricular introducer from the catheter (see the removal instructions of the catheter manufacturer). Test for cerebrospinal fluid (CSF) manometrics.