Tracoe 450-P Instrucciones De Uso página 36

of the disconnect wedge between the 15 mm connector and external device until the two devices
are separated, chapter "Supplementary Products".
Caution:
• Do not use unnecessary force on the tracheostomy tube when connecting to or discon-
necting from external devices. This may result in damage of the tracheostomy tube and/or dis-
placement / decannulation.
8.7 Subglottic Suction
1. To perform intermittent suctioning, remove the cap of the subglottic suction line Luer connector.
2a. Manual suctioning can be carried out using a syringe.
2b. An active suction device can be connected using the adaptors, (see image 5).
3. Following subglottic suctioning, reseal the suction line Luer connector with the cap.
Caution:
• If the suction channel is obstructed, it can be cleared by inflation of air/ oxygen (recom-
mended 3 – 6 l/min; max. 12l/min) or it can be rinsed with saline solution (recommended 2 – 3 ml).
Do not exceed the recommended limits and take care of the patient's individual tolerability. The
following side-effects could occur: Accumulation of potentially contaminated secretions, discom-
fort, nausea and retching, excessive secretions.
• Before rinsing the suction line, make sure that the cuff is sufficiently inflated.
• Remove the applied saline immediately after rinsing the suction line.
• If the suction line doesn't get cleared, the tube must be changed.
8.8 Above Cuff Vocalisation
Caution:
• ACV must be performed by professional personnel.
ACV is used to provide phonation capabilities for the patient. Therefore, it must be adjusted to the
individual patient's needs and abilities. It is essential that the patient is instructed and involved in
every step of ACV to ensure cooperation and good results during the application.
Before using ACV ensure that the patient is wearing a tracheostomy tube with permanently inflated
cuff and does not tolerate cuff deflation. If needed, air can be humidified before inflation through
the subglottic suction line to prevent the laryngeal mucosa from drying out.
1. Explain the planned procedure to the patient. Indicate possible adverse reactions and clarify
patient's questions.
2. Verify that the upper airways are not obstructed.
3. Clear the subglottic space from secretions using subglottic suctioning.
4. Verify that the suction line is not obstructed.
5. Connect properly the adjustable air or oxygen supply via a fingertip connector to the female Luer
connector of the subglottic suction line. Alternatively, other devices for interruption of the perma-
nent airflow may be used (e.g. Y-connector).
6. Inflate air slowly into the upper airways of the patient starting with 1 l/min and slowly rising to a
typical flow rate of 3 – 6 l/min depending on the patients' requirements. To may reduce laryngeal
mucosa from drying out, flow rates must not exceed 12 l/min. Use the fingertip connector to limit
the air flow time. This timeframe should be adapted to the patient's exhaling rhythm. Adjust airflow
and time within the comfort zone of the patient.
7. Monitor the patient's reaction and adjust parameters (flow and time of airflow) as necessary.
8. When the session is finished, turn off the air flow and disconnect the equipment from the sub-
glottic suction line connector and replace the cap.
EN
33