DisImpactor ™ Your least favorite job just got a whole lot easier. NuvoMed DisImpactor™ Tool User Guide 3 4 6 8 10 15 2 | NuvoMed DisImpactor™ Tool – User Guide The DisImpactor™ Tool is a single use manual gastroenterology instrument intended for use in the treatment of fecal impaction in patients 18 years of age or is not intended to treat constipation and should not be used Hemodynamic instability, mental status changes, renal failure, hyperkalemia, active anticoagulation, known anal and/or rectal disease including neoplasm, active gastroenterological or systemic condition that may pose a NuvoMed DisImpactor™ Tool – User Guide | 3 instrument that provides an alternative to manual digital need to clean the device and provides the convenience of Use of a DisImpactor Tool facilitates the removal of a fecal mass through the combined effect of these elements: The head of the DisImpactor Tool is designed to penetrate the impacted fecal mass in order to develop a mechanical grip that facilitates removal the shaft of the device help to physically break up the When used to deliver an enema, design of the device allows for deep enema placement, particularly once the impaction has been disrupted and 4 | NuvoMed DisImpactor™ Tool – User Guide Patients often experience pain with digital disimpaction disimpaction may be avoided when using a DisImpactor NuvoMed DisImpactor™ Tool – User Guide | 5 6 | NuvoMed DisImpactor™ Tool – User Guide Designed to be simple, safe and effective removal Point of Impact™ delivery system for deep enema penetration at site of impaction manipulation Minimized pain and embarrassment of digital disimpaction Improved procedure for all involved Relief without hospitalization Makes enema more effective in removal of impaction No sterilization or cleaning required NuvoMed DisImpactor™ Tool – User Guide | 7 Due to the possibility of serious injury to the patient, the DisImpactor Tool is intended for use by trained, medically 8 | NuvoMed DisImpactor™ Tool – User Guide device with or without accompanying use of an enema at Multiple training options are available to users on the NuvoMed website ( ) or provided by your NuvoMed distributor: User Guide Online instructions for use NuvoMed DisImpactor™ Tool – User Guide | 9 be connected to the DisImpactor Tool via the included IV Equipment laid out for use without enema 10 | NuvoMed DisImpactor™ Tool – User Guide Equipment laid out for use with enema Position the patient lying on his or her side with the knees Drape the patient, and place several barrier pads NuvoMed DisImpactor™ Tool – User Guide | 11 With the patient lying on his or her side, gently insert a With the patient still gently bearing down, carefully and slowly utilizing light manual pressure and a gentle clockwise/ remain within the center of the fecal mass and along the long Gently advance the DisImpactor Tool into the center of may not exceed the length of the device, nor is full DO NOT USE To begin the withdrawal of stool, ask the patient to bear down again while gently withdrawing the DisImpactor Tool combination of gentle traction and attempted defecation complete, remove the entire device, inspect its integrity, » » If a single round of disimpaction does not relieve the fecal impaction, use a second, fresh DisImpactor Tool 12 | NuvoMed DisImpactor™ Tool – User Guide If fecal impaction persists after two attempts to remove the fecal mass, a new, fresh DisImpactor Tool can be tool into the rectum utilizing light manual pressure and a DisImpactor Tool must remain along the long axis of the Gently insert a DisImpactor Tool to an appropriate Discard the used device, tubing, and syringes into a If necessary, the patient may be allowed to evacuate at an NuvoMed DisImpactor™ Tool – User Guide | 13 » not completely relieve the impaction, disimpaction may be performed again with another DisImpactor Tool to » If residual impaction persists, a second enema using » If impaction persists following a second enema, or magnesium citrate) may be considered when » Most patients will experience relief of their impaction incomplete relief, clinical judgment must be utilized to 14 | NuvoMed DisImpactor™ Tool – User Guide available on the website and via phone: NuvoMed DisImpactor™ Tool – User Guide | 15