Fahl TRACHEOTEC Instrucciones De Uso página 22

CAUTION!
All instruments used for inflating the cuff must be clean and free of foreign particles!
Detach the instruments from the Luer connection of the inflation tube as soon as the
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cuff has been inflated and close the connection with the cap.
CAUTION!
If the maximum pressure is exceeded for longer periods of time, the blood circulation
in the mucus membrane can be impaired (risk of ischaemic necrosis, pressure ulcers,
tracheomalacia, tracheal stenosis, pneumothorax). In patients undergoing artificial
respiration, the cuff pressure should not be allowed to drop below the cuff pressure
value specified by the doctor/physician in order to prevent unnoticed aspiration.
Hissing noises in the region of the balloon, especially during expiration, indicate that
the trachea is insufficiently sealed by the balloon. If the trachea cannot be sealed
with the pressure values specified by the doctor/physician, the entire air should be
withdrawn again from the balloon and the sealing process should be repeated. If this
does not lead to success, we recommend to use the next larger tracheostomy tube
with balloon. Due to the permeability of the balloon wall for gases, it is normal for the
pressure in the balloon to decline slightly over time, but it can on the other hand also
rise unintentionally during gas anaesthesia. Regular pressure monitoring is therefore
urgently recommended.
The cuff must never under any circumstances be inflated with excessive amounts of
air, since this can lead to damage of the tracheal wall, tears in the low pressure cuff
with subsequent deflation, or distortion of the cuff, in which case airway obstruction
cannot be ruled out.
CAUTION!
During anaesthesia, the cuff pressure can rise/fall due to nitrous oxide (laughing gas).
2. Removing the tube
CAUTION!
Accessories such as a tracheostoma valve or HME (Heat Moisture Exchanger) must
be removed first before proceeding to remove the Fahl tracheostomy tube.
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CAUTION!
If the tracheostoma is unstable, or in emergency situations (puncture/dilation
tracheostomy), the tracheostoma can collapse after withdrawal of the tracheostomy
tube, thereby impairing air supply. A fresh tracheostomy tube must be kept ready for
use in such cases and must be quickly inserted if necessary. A tracheal dilator (REF
35500) can be used for temporarily securing the air supply.
The cuff must be emptied before removing the tracheostomy tube. The head should
be tilted back slightly for removal of the tube.
CAUTION!
Never use a cuff pressure gauge to empty the low-pressure cuff. Always use a
syringe for this.
Before the air is removed from the balloon by means of a syringe and the tracheostomy
tube is withdrawn, the region of the trachea above the balloon must first be cleaned by
suctioning off secretions and mucus. If the patient is responsive and reflexes are intact,
it is recommended that the patient be suctioned while at the same time unblocking the
tracheostomy tube. Suctioning is performed by inserting a suction catheter through the
cannula tube into the trachea. In this way, suctioning can be performed without any problems
and gently for the patient and cough stimulus and the risk of aspiration are minimised.
Next, deflate the low pressure cuff while suctioning off at same time.
If secretions are present, these are now taken up by the suction tube and can no
longer be aspirated. Please note that the tracheostomy tube must in every case be
cleaned, if necessary disinfected, and lubricated with stoma oil as specified below
prior to reinsertion.
Proceed very carefully to avoid injury to the mucus membranes.
The tube must always be cleaned and, if necessary, disinfected as follows before re-
inserting according to the instructions provided below.
tracheostomy tubes:
Step-by-step instructions to remove the Fahl
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The tracheostomy tubes should be removed with the head slightly tilted back. Grip the tube
or button at the side by the neck flange or the housing (see picture 7).
Carefully remove the tracheostomy tubes.
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