1. 1 Today’s Technology to Keep Access Sites Dry and Intact

2. 2 The Challenge A major source of catheter-related infection is soiled, wet or loose dressings caused by bleeding or oozing at insertion sites and/or diaphoresis. The Centers for Disease Control (CDC) Guidelines for Prevention of Intravascular Catheter-Related Infections include recommendations to:  Replace catheter-site dressing if the dressing becomes damp, loosened, or visibly soiled; therefore, keep catheter site dry and intact.  Replace dressings used on short-term CVC sites every 2 days for gauze dressings and at least every 7 days for transparent dressings. How do you keep access sites dry and intact? Photos by Penny Offer, CRNI Site without BioSeal CVC – soiled dressing Site with BioSeal CVC – Dry/intact dressing 0- 7days

3. 3 3 The Solution: BioSeal CVC Powder The ingredients are a mixture of a hydrophilic polymer and a potassium ferrate. BioSeal CVC Powder is not a vasoconstrictor, or a cauterizing agent. It is non- systemic, non-toxic and it is not biologically derived. BioSeal CVC Powder, formerly PRO QR Powder, is a topical powder that forms an occlusive seal to stop the flow of blood and exudates and keep microbes from entering the site.

4. 4 4 Proven Efficacy Results from a product trial** of BioSeal CVC (PRO QR) usage for 418 PICC lines at a large Florida hospital: Time to Hemostasis (including patients with clotting difficulties) ≤ 2 minutes in 96% of applications Elimination of 24-48 hour dressing change (first dressing change at 7 days) 100% Total reported complications0 Reduction in Catheter-Related Bloodstream Infections (CRBSIs) 40% **Trial results on file at Biolife.

5. 5 5 How Does the Powder Work?  The mechanism of action is a simultaneous two-step action whereby the hydrophilic polymer rapidly dehydrates the blood and absorbs exudates while the potassium ferrate binds with the blood proteins to create an occlusive seal.  As the blood becomes dehydrated, the “nothing in, nothing out” seal thickens until blood and nutrient-rich exudates can no longer permeate through the seal. The seal creates a hostile barrier to microbes on the distal side, while maintaining a neutral environment on the proximal side. For more on the mechanism of action, see the video at: http://www.youtube.com/watch?v=00bcKWOFTrs http://www.youtube.com/watch?v=00bcKWOFTrs Actual scanning electron microscopy (SEM) image BioSeal CVC Powder

6. 6 6 The Difference is the Seal The seal:  Allows “nothing in/nothing out”  Keeps sites dry and intact  Minimizes complications from bleeding/exudate leakage  Eliminates unnecessary dressing changes  Fits all sizes of lines or tubes  Increases patient satisfaction SEM photography of a 5 Fr. Catheter. Note the occlusive seal that has formed around the line. Seal the site, don’t just patch it. TM Extra powder Seal

7. 7 7 BioSeal Creates a Sustained Hostile Environment Above the Seal Bacteria, full of water and salts, come in contact with the BioSeal CVC powder on the top side of the seal. (H 2 0 & Ca ++, Na +, K + ) The bacteria dries (desiccation) The moisture pulled from the bacteria contain salts. The cations of these salts are exchanged for H+ (acidic), creating a low pH environment (~2) above the seal. The Seal Composed of coagulated blood components Below the seal the pH is ~ neutral Above the seal the pH is ~ 2 Below the Seal The BioSeal CVC Powder floats on the blood, therefore it doesn’t penetrate the seal. This results in a neutral pH below the seal. (The pH below the seal was measured @ 7.4 in a saline extraction of a laboratory-created seal.)

8. 8 8 Key Applications Use BioSeal CVC Powder with the following devices to stop bleeding and oozing and protect the site: Vascular Devices: (insertions and removal)  PICCs/Midlines  Central Venous Catheters  Dialysis Catheters  Arterial Catheters (maintenance) Also effective in controlling bleeding and exudate leakage from Non-Vascular Devices such as:  Peritoneal dialysis catheters  Epidural catheters  Large-bore needles used for paracentesis, thoracentesis, or biopsies  PEG/Gastrostomy feeding tubes Photo by Penny Offer, CRNI

9. 9 BioSeal CVC Application – Tips for Success Do’s: To ensure success, secure the line with securement device before applying powder Apply firm pressure for two minutes directly over wound with dry, gloved fingers or non-adherent dressing to form the protective seal and achieve hemostasis. Roll fingers off of site to release pressure Leave seal over wound; the “BioSeal” will fall off naturally on its own, or if needed, may be removed with sterile technique. Don’ts: Do not hold pressure over BioSeal powder with gauze to avoid tearing the seal (use dry, gloved fingers instead). Do not check for hemostasis before the recommended holding time complete. This could disturb the strengthening seal. Pour Powder Hold Pressure Seal is formed Photos by Penny Offer, CRNI

10. 10 Additional Clinical Studies Further clinical studies have been completed and data is available for the following BioSeal CVC Powder applications:  Vascular Access (arterial and venous)  Mohs Surgery  Wound dehiscence Ask your sales representative for further information including clinical references.

11. 11 Educational Tools Brochures for Patients and Medical Staff Posters Protocols Computer-based Learning Modules Other support at www.biosealcvc.comwww.biosealcvc.com

12. 12 BIOSEAL CVC Ordering Information Order NumberProduct Description LP6066 Applications per Box* LP63624 Applications per Case* * Each application includes bottle, PCD, product description label and Patient Discharge Instructions.

13. 13 More Biolife Products BioSeal Advanced  Biolife’s powder technology that controls external bleeding from arterial access procedures PRO QR for Nosebleeds  Topical powder that stops anterior nosebleeds and other hard to reach wounds in a convenient package with an applicator Other Biolife product offerings include:

14. 14 For More Information  Call Biolife at 800-722-7559  Visit www.biosealcvc.comwww.biosealcvc.com