Fahl DURACUFF Manual De Instrucciones página 20

MRT is a diagnostic imaging technique in which inner organs, tissues and joints are depicted with the
help of magnetic fields and radio waves. Metallic objects can be drawn into the magnetic field and can
induce changes by their acceleration. Although the metal spring is extremely small and lightweight,
interactions that could give rise to health impairments or to malfunction or damage of the technical
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equipment used or of the tracheostomy tube itself nevertheless cannot be ruled out in this context.
If wearing a tracheostomy tube is indicated for keeping the tracheostoma open, we recommend use
of a metal-free tracheostomy tube instead of the tracheostomy tube with cuff while an MRT is being
performed.
CAUTION!
Do not use a tracheostomy tube with low-pressure cuff while undergoing a nuclear magnetic
resonance tomography / MRT!
1. Neck flange
A particular feature of the Fahl tracheostomy tube is the specially shaped neck flange, which is
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designed to fit the anatomy of the neck.
The size specifications are printed on the neck flange.
The neck flange of the tracheostomy tubes has two side eyelets for inserting a tube holder.
All Fahl tracheostomy tubes with fastening eyelets include a disposable tube holder. The tube holder
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secures the tracheostomy tube to the neck.
The medium-length cannulas (see size table in the appendix) are colour-coded by means of a yellow
ring on the inner cannula and the yellow imprint on the neck flange of the cannula as well as on the
pilot balloon.
The insertion aid (obturator) included in delivery facilitates insertion of the tracheostomy tube.
Please follow the instructions provided with the tube holder carefully when attaching and removing it
from your tracheostomy tube.
Ensure that the Fahl tracheostomy tube is placed in the tracheostoma without tension and the position
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is not changed when fastening the tube holder.
2. Connectors and adapters
Connectors and adapters are used to connect compatible tube accessories.
The options available to a patient depend on the clinical condition, such as status post laryngectomy
or tracheostomy.
Connectors/adapters are normally permanently attached to the inner cannula. The connector in this
case is the universal (15 mm) connector with the aid of which so-called artificial noses or heat and
moisture exchangers (HMEs, filters for exchanging heat and moisture) can be attached.
This connector is also available in a special version as 15 mm swivel connector. The swivel version
of the 15 mm connector is suitable, for instance when using a respirator tube system, for absorbing
the torsional forces which arise in such situations and to relieve strain on the tracheostomy tube and
stabilise it in position so that irritations of the mucous membrane in the trachea are minimized.
The 22 mm combi-adapter can be used to fasten compatible filter and valve systems with 22 mm
attachments – such as , but not limited to the HUMIDOPHONE
speaking valve with filter function (REF
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46480), HUMIDOTWIN Heat and Moisture Exchanger (HME) (REF 46460), COMBIPHON speaking
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valve (REF 27131), LARYVOX HME filter cassettes (REF 49800).
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3. Cannula tube
The cannula tube borders directly on the neck flange and directs the airflow into the trachea.
The Easy Lock hexagonal lock serves to securely attach inner cannulas and compatible accessories.
The X-ray contrast strip in the tube that runs along the side allows the tube to be depicted
radiographically and the position of the tube to be checked.
3.1. Low-pressure cuff
In the product versions with low-pressure cuff, the very thin-walled, high-volume low-pressure cuff
adapts well to the trachea and ensures reliable sealing if inflated correctly. The low-pressure cuff can be
inflated like a balloon. The small pilot balloon on the inflation tube indicates whether the tracheostomy
tube is in sealed (inflated) or non-sealed condition.
The low pressure cuff is inflated via a pilot line with one-way valve and pilot balloon.
3.1.1 Leakproofness test of the cannula and the low-pressure cuff (if present)
The cannula and the low pressure cuff must be tested for leakages directly before and
after every insertion and thereafter at regular intervals. For this purpose, inflate the low-
pressure cuff to 15 to 22 mmHg (1 mmHg corresponds to 1.35951 cmH2O) and then observe
whether a spontaneous drop in pressure occurs (recommended for inflating and testing:
Cuff pressure gauge control inflator, REF 19500). There should be no substantial drop in pressure
during the observation period. This leakproofness test must also be performed prior to every renewed
insertion (e.g. after cleaning the tracheostomy tube) (see picture 7c).
The following are possible signs indicating leakages in the cuff (balloon):
- Externally visible damage to the balloon (holes, fissures etc.)
- Audible and/or tactile perception of air escaping from the balloon
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