Medtronic COVIDIEN Shiley Mode D'emploi page 6

Insertion
CAUTION:
To ease insertion and to guard against cuff perforation from sharp edges of
cartilage, the cuff should be tapered back. This can be accomplished by first
inflating the cuff. Then gently move the cuff away from the distal tip of the outer
cannula towards the swivel neck plate as the residual air is removed by deflation.
Do not use any sharp instruments such as forceps or hemostats that would
damage the cuff when tapering it.
3. Remove the non-fenestrated inner cannula with the white 15mm connector and
insert the obturator into the outer cannula. The obturator should be fully seated
before the tube is inserted into the patient. A thin film of water soluble lubricant
can be applied to the outer cannula, cuff (LPC, FEN), and protruding portion of the
obturator to facilitate insertion.
4. After the tracheotomy procedure is performed, insert the tube into the patient's
trachea. After the tube is properly in place, remove the obturator immediately.
CAUTIONS:
When using a water soluble lubricant verify that the lubricant does not enter and
occlude the tube lumen which may restrict ventilation.
The obturator should be cleaned and then stored in an accessible location near the
patient should it be needed for an unscheduled re-intubation.
WARNINGS:
ALL INNER CANNULAE WITH TWIST-LOCK CONNECTORS PROVIDED IN THIS
PACKAGE SHOULD NOT BE USED ON ANY OTHER TUBE BECAUSE THEY ARE
FITTED TO THE EXACT LENGTH OF THIS TUBE.
DURING AND AFTER ATTACHMENT OF RESPIRATORY OR ANESTHESIA TUBING
AND/OR CONNECTORS TO THE INNER CANNULA, AVOID APPLICATION OF
EXCESSIVE ROTATIONAL, LINEAR, OR ROCKING FORCES ON THE TUBING AND/
OR CONNECTORS TO PREVENT ACCIDENTAL DISCONNECTION OF THE INNER
CANNULA, OR DAMAGE TO THE TRACHEOSTOMY TUBE.
5. Prior to inserting the inner cannula, establish the patency of the patient's
upper airway track. The patient's airway should be cleared by coughing and/
or suctioning. Moisten the non-fenestrated inner cannula with white 15 mm
connector with sterile saline to facilitate insertion. To lock the non-fenestrated
inner cannula in place, hold the swivel neck plate firmly with your fingertips and
twist the connector clockwise, one-quarter turn past the locking detent. The
outer cannula should always be used with the inner cannula in place unless the
Decannulation Plug (DCP) is being used.
6. To insert the fenestrated inner cannula with the green 15 mm connector (FEN,
CFN), establish the patency of the patient's upper airway track. The patient's airway
or
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