Fahl TRACHEOTEC Gebrauchsanweisung Seite 17

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
®
secures the tracheostomy tube to the neck.
Ensure that the Fahl tracheostomy tube is placed in the tracheostoma without tension and the position
®
is not changed when fastening the tube holder.
The insertion aid (obturator) included in delivery facilitates insertion of the tracheostomy tube.
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.
A 15 mm standard connector enables secure connection to required accessories.
3. Cannula tube
The cannula tube borders directly on the neck flange and directs the airflow into the trachea.
The X-ray contrast strip in the tube that runs along the side allows the tube to be depicted radiographi-
cally and the position of the tube to be checked.
In the Suction tracheostomy tube versions, the X-ray contrast strip runs along the middle of the cannula
tube.
3.1 Cuff
In the product versions with cuff, the very thin-walled, high-volume cuff adapts well to the trachea
and ensures reliable sealing if inflated correctly. The 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 cuff itself is inflated via a tube 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 inser-
tion and thereafter at regular intervals. For this purpose, inflate the low-pressure cuff to 15 to 22 mm Hg
(1 mm Hg corresponds to 1.35951 cmH
occurs (recommended for inflating and testing: Cuff pressure gauge control inflator). 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
•
Water in inlet tubes of the tracheostomy tube (after cleaning!)
•
Water in the cuff (after cleaning!)
•
Water in the pilot balloon (after cleaning!)
•
No cough stimulus when pressure is applied to the pilot balloon
CAUTION!
When testing the balloon or when inserting, removing or cleaning the tracheostomy tube, never
under any circumstances use sharp or pointed objects, such as for instance forceps or clamps,
since these can damage or even destroy the balloon. Should one of the above-named signs of
leakage be detectable, the tracheostomy tube must under no circumstances be used any more
since it is no longer functioning properly!
3.2 Obturator
Please check whether the obturator can easily be removed from the cannula before inserting the tra-
cheostomy tube! After checking the obturator for ease of movement, reinsert the obturator into the
cannula for inserting the tracheostomy tube.
3.3 Suction opening (only in Suction tracheostomy tube versions)
Secretions that have accumulated above the inflated cuff can be removed via the suction opening in the
outer tube of the Suction tracheostomy tubes.
The suction tube leading to the outside can be connected to a syringe or a suction device. The user
must decide in consultation with the treating physician and after appropriate risk analysis, which of these
suctioning variants to use. The individual disease condition of the patient should be considered in this
context.
Suctioning using a suctioning device may in any case only be performed if the suctioning device is
equipped with vacuum adjuster. The suction pressure must never exceed – 0.2 bar.
When using the suction variants of the tracheostomy tubes, the secretions that have accumulated abo-
ve the cuff must be suctioned off via the suction opening on the tracheostomy tube directly before defla-
ting the cuff in order to prevent aspiration of secretions. In this way, additional suctioning with a suction
catheter while deflating the cuff may be rendered unnecessary, which facilitates handling significantly.
CAUTION!
When using any of the tracheostomy tube versions with a suctioning device („SUCTION"), take
special care during the suctioning procedure to generate a vacuum for as short a time as pos-
sible; drying out of the subglottic space as a result of this must be avoided.
O) and then observe whether a spontaneous drop in pressure
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EN