Fahl DURATWIX JUNIOR Manual Del Usuario página 17

The tracheostomy tubes should always be attached with a special tube holder. This stabili-
ses the tube and thus ensures that the tracheostomy tube is securely seated in the tracheo-
stoma (see picture 1).
EN
1.1 Inflating the cuff (if such exists)
The cuff is inflated by applying a defined pressure to the cuff via the Luer connection (stan-
dardised conical connection) of the inflation tube by means of a cuff pressure gauge.
The cuff pressure varies from patient to patient and should be determined by medical per-
sonnel based on the individual circumstances of the patient.
Fill the cuff according to the previously determined cuff pressure and make sure that there
is sufficient air supply through the tracheostomy tube.
Always make sure that the cuff is undamaged and is functioning faultlessly.
If the desired sealing is not achieved even after repeated attempts with the specified limit
volume, a tracheostomy tube with larger diameter may be indicated.
The correct cuff pressure must be checked regularly, i.e. at least every 2 hours.
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
cuff has been inflated.
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 pressu-
re 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withdrawn again from the balloon and the sealing process should be repeated.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 cuff with subse-
quent deflation, or deformation 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 tra-
cheostomy), 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 cuff. Always use a syringe for this.
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