Relative Contraindications - Tracoe twist REF 301 Instrucciones De Uso

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4.2

Relative contraindications

Relative contraindications are cases where the risks and benefits
of the procedure must be carefully evaluated:
• Paediatric use.
• Unusually deep trachea, e.g. in obese patients, where a
longer tube may be required.
5. General Precautions
• You are strongly advised to keep a ready-to-use spare
tube and several spare inner cannulas at the patient's bedside.
Store in a clean and dry state.
• Check the tube for integrity and correct function prior to
use/insertion. Check, for example, for the absence of obstruction,
cuff seal, correct and stable fit of the inner cannula inside the
outer cannula, absence of kinks, stable connection between the
tube and neck flange, etc. The cuff material must not be brittle. If
the product is damaged, replace with a new product.
• Do not use force on the tracheostomy tube, as this may
damage or break it. If the connections at the 15 mm connector
are tightly fixed, always use a disconnect wedge approved for
tracheostomy tubes.
• Keep the 15 mm connector (3) clean and dry.
• When changing the inner cannula, always ensure that the
inflation line (2a) of the cuff is not positioned between the inner
and outer cannulas, as it may get trapped and damaged.
• When repositioning the patient in bed, ensure that the
patient does not lie on the pilot balloon (2a), as this would greatly
increase the cuff pressure and may damage the trachea.
• During mechanical ventilation and frequent changes of
the patient's position or manipulation of the tube, the inner cannu-
la may become separated from the outer cannula.
• With the use of high ventilation pressures, leakage be-
tween the inner and outer cannulas may occur in isolated cases.
• The use of tracheostomy tubes can lead to pressure
points, necrosis of the skin on the neck and skin irritation (e.g.
moisture). To avoid this, we recommend placing a pad under-
neath the neck flange.
• To avoid damage to the material, the cuff should not be in
contact with lidocaine-containing aerosols or any ointments.
• All components of the cuff inflation system must be kink-
free and not taut when testing the cuff pressure. The hand-held
manometer may otherwise give a false pressure reading.
• Thin cuffs are to some extent permeable to water va-
pour. Therefore, condensate may accumulate in the cuff. Where
quantities are small, this is of no significance. However, if larger
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