Fahl TRACHEOSILC Manual Del Usuario página 16

CAUTION!
Contraindicated in patients with increased bleeding tendency (e.g. during anticoagulant
therapy). In such cases, the Suction tracheostomy tube with suction opening may not be used,
since suctioning entails an increased risk.
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VIII. DIRECTIONS FOR TUBE INSERTION AND REMOVAL
For the Doctor/Physician
The appropriate tracheostomy tube must be selected by a doctor/physician or trained medical
professionals.
Select a tube that fits the patient's anatomy to optimise comfort and ventilation (breathing in and out).
For the Patient
CAUTION!
Always insert the tracheostomy tube with the cuff in fully deflated condition (see picture 7a)!
CAUTION!
Carefully examine the sterile packaging to ensure that it has not been tampered with or
damaged. Do not use the product if the packaging has been damaged.
Check the use-by or expiry date. Do not use after this date.
It is advisable to use sterile disposable gloves.
Carefully examine the tube before first use to make sure that it is not damaged and that there are no
loose parts.
Should you notice any anomaly or anything unusual, DO NOT use the tube. Return the tube to the
manufacturer for inspection.
The neck flange respectively the funnel-shaped housing (retainer ring) must not be inserted into the
tracheostoma. Make sure that it is always outside the tracheostoma (see picture 2).
If secretion collects in the lumen of the Fahl tracheostomy tube and cannot be removed by coughing
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or aspiration, the tube should be removed.
1. Insertion of the tube
Step-by-step instructions to insert Fahl tracheostomy tubes.
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Before application, users should clean their hands (see picture 3).
Remove tube from the package (see picture 4).
If an obturator is to be used, this must first be fully inserted into the cannula tube so that the collar on
the gripping piece of the obturator comes into contact with the outer edge of the 15 mm connector and
the tip of the olive projects beyond the tip of the cannula (proximal end of cannula). The obturator must
be held in this position during the entire procedure.
When using tracheostomy tubes with cuff, pay special attention to the following points:
Before inserting the tracheostomy tube, check the cuff (balloon) as well - the cuff must be free of
damages of any kind and must be leakproof so as to ensure tight sealing as required. We therefore
recommend to perform a leakproofness test prior to every insertion (see Section VII, 3.1.1 / 3.1.2).
The balloon must be completely empty prior to insertion of the tracheostomy tube (see picture 7b)!
When using an aid for dilating the tracheostoma, take care to ensure that the tracheostomy tube, and
especially the cuff, is not damaged by friction.
Then a tracheal compress is pushed onto the tracheostomy tube.
To increase the lubricity of the tracheostomy tube and thus facilitate insertion into the trachea, it is
recommended to wipe the outer tube with an OPTIFLUID stoma oil wipe (REF 31550), which allows
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even distribution of the stoma oil on the tube (see Figs. 4a and 4b) or FAHL OPTIFLUID Lubricant
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Gel 20g tube (REF 36100) or FAHL OPTIFLUID Lubricant Gel 3g sachet (Ref 36105).
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If you are inserting the tube yourself, use a mirror to make insertion of the Fahl tracheostomy tube
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easier.
When inserting the Fahl tracheostomy tube, hold it by the neck flange with one hand (see picture 5).
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Pull the tracheostoma slightly apart with your free hand to allow the tip of the tube to fit into the
tracheostoma more easily.
Special aids for dilating the tracheostoma are also available (tracheal dilator, REF 35500). These
allow the tracheostoma to be dilated gently and evenly, for instance also in emergency situations with
collapsing tracheostoma (see picture 6).
Make sure that the tube is not damaged by friction when using an instrument for assistance.
Now carefully insert the tube into the tracheostoma during the inspiration phase (while breathing in)
while tilting your head slightly back (see picture 7).
Advance the tube into the trachea.
Straighten your head once the tube has been inserted further into the trachea.
If an obturator is used, this must then immediately be removed from the tracheostomy tube.
The tracheostomy tubes should always be attached with a special tube holder. This stabilises the tube
and thus ensures that the tracheostomy tube is securely seated in the tracheostoma (see picture 1).
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