Fahl TRACHEOSILC Manual Del Usuario página 15

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
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non-sealed condition.
The cuff itself is inflated via a tube with one-way valve and pilot balloon.
CAUTION!
Remove the safety protector of the valve on the pilot balloon if such is present (see picture 17).
3.1.1 Leakproofness test of the cannula and the cuff (if such exists)
The cannula and the cuff must be tested for leakages directly before and after every insertion and
thereafter at regular intervals.
For this purpose, fill the cuff with 18 to 22 mmHg (1 mmHg corresponds to 1.35951 cmH2O) and
observe whether a spontaneous pressure drop occurs.
There should be no substantial drop in pressure in the cuff 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).
3.1.2 Leakproofness test of the cannula and the high-pressure cuff (if such exists)
The high-pressure cuff is inflated exclusively using a syringe. The optimal inflation of the high-pressure
cuff has been reached when no leakage can be heard anymore or the ventilator machine no longer
indicates a leakage.
CAUTION!
The inflation volume of the high-pressure cuff must be specified by the physician.
Never under any circumstances use a cuff pressure gauge to inflate the high-pressure cuff.
Observe the maximum inflation volume of the cuff (see table of sizes).
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 or removing 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
tracheostomy tube! After checking the obturator for ease of movement, reinsert the obturator into the
cannula for inserting the tracheostomy tube.
The insertion aid serves to stabilise the tracheostomy tube during insertion into the tracheostoma.
Insertion aids are single-patient products and are intended for single use only. They must not be
cleaned or disinfected.
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
above the cuff must be suctioned off via the suction opening on the tracheostomy tube directly before
deflating 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
possible; drying out of the subglottic space as a result of this must be avoided.
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