Fahl DURACUFF Manual De Instrucciones página 24

CAUTION!
Carefully examine the sterile packaging to ensure that it has not been tampered with or damaged.
Do not use the product if the packaging has been damaged.
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Check the use-by or expiry date. Do not use after this date.
It is advisable to use sterile disposable gloves.
Carefully examine the tube before first use to make sure that it is not damaged and that there are no
loose parts.
Should you notice any anomaly or anything unusual, DO NOT use the tube. Return the tube to the
manufacturer for inspection.
The tube must always be cleaned and, if necessary, disinfected as follows before re-inserting according
to the instructions provided below.
If secretion collects in the lumen of the Fahl tracheostomy tube or stoma button and cannot be
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removed by coughing or aspiration, the tube should be removed and cleaned.
After cleaning and/or disinfection, carefully examine the Fahl tracheostomy tube for sharp edges,
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cracks, or other signs of damage, since these may impair function and/or injure the mucus membranes
in the airways.
Never under any circumstances continue using damaged tracheostomy tubes.
WARNING
Patients must be briefed by trained medical professionals in the safe use of the Fahl
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tracheostomy tubes.
1. Insertion of the tube
Step-by-step instructions to insert Fahl tracheostomy tubes.
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Before application, users should clean their hands (see picture 3).
Remove tube from the package (see picture 4).
If an obturator is to be used, this must first be fully inserted into the cannula tube so that the collar on
the gripping piece of the obturator comes into contact with the outer edge of the 15 mm connector and
the tip of the olive projects beyond the tip of the cannula (proximal end of cannula). The obturator must
be held in this position during the entire procedure.
When using tracheostomy tubes with low-pressure cuff, pay special attention to the following
points:
Before inserting the tracheostomy tube, check the cuff (balloon) as well - it must be free of damages
of any kind and must be leakproof so as to ensure tight sealing as required. We therefore recommend
to perform a leakproofness test prior to every insertion (see Section VII, No. 3.1.1). The balloon must
be emptied completely prior to insertion of the tracheostomy tube (see picture 7b)! When using an aid
for dilating the tracheostoma, take care to ensure that the tracheostomy tube, and especially the cuff,
is not damaged by friction.
Next, push a tracheal compress, e.g. SENSOTRACH DUO (REF 30608) or SENSOTRACH 3-Plus
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(REF 30780), onto the tracheostomy tube.
To facilitate insertion of the tracheostomy tube, it is advisable to lubricate the outer tube by wiping it
with an OPTIFLUID stoma oil wipe (REF 31550) which allows the stoma oil to be applied evenly to the
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whole surface of the tube (see picture 4a and 4b).
If you are inserting the tube yourself, use a mirror to make insertion of the Fahl tracheostomy tube
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easier.
When inserting the Fahl tracheostomy tube, hold it by the neck flange with one hand (see picture 5).
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Pull the tracheostoma slightly apart with your free hand to allow the tip of the tube to fit into the
tracheostoma more easily.
Special aids for dilating the tracheostoma are also available (tracheal dilator, REF 35500). These
allow the tracheostoma to be dilated gently and evenly, for instance also in emergency situations with
collapsing tracheostoma (see picture 6).
Make sure that the tube is not damaged by friction when using an instrument for assistance.
Now carefully insert the tube into the tracheostoma during the inspiration phase (while breathing in)
while tilting your head slightly back (see picture 7).
Advance the tube into the trachea.
Straighten your head once the tube has been inserted further into the trachea.
If an obturator is used, this must then immediately be removed from the tracheostomy tube.
The tracheostomy tubes should always be attached with a special tube holder. This stabilises the tube
and thus ensures that the tracheostomy tube is securely seated in the tracheostoma (see picture 1).
1.1 Inflating the low-pressure cuff (if present)
The low-pressure cuff is inflated by applying a defined pressure to the cuff via the Luer connection
(standardised conical connection) of the inflation tube by means of a cuff pressure gauge
(e.g.MUCOPROTECT , REF 19500). If not instructed otherwise by the doctor/physician, we
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recommend a cuff pressure of at least 15 mmHg (20 cmH2O) to 22 mmHg (30 cmH2O). The cuff
pressure should never under any circumstances exceed 22 m Hg (approx. 30 cmH2O).
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