Teleflex TracheoFlex RUSCH Mode D'emploi page 4

A) Suggested Directions for Use
1.
Selection of the correct tube size
The correct choice of tube size depends on the size and shape of the
individual tracheostoma, the diameter of the trachea and the patient's
underlying disease and is primarily the responsibility of the attending
physician. In general, the largest possible tube that will fit both the
trachea and the tracheostoma on the basis of the patient's anatomy
should be selected to ensure optimum ventilation of the lungs and,
at the same time, the lowest possible airway resistance.
2.
Preparation of the tracheostomy tube
• Prior to use, check that the set is complete and functions correctly.
• When using cannulas with cuff, the patency of the tube lumen and
cuff filling system should be checked before intubation.
Prior to use, check that the cuff, the pilot balloon and the valve are
intact and have no leaks.
In order to check that the system is leaktight, fill the cuff with air
using a syringe (see table for inflation volume of leakage test), then
remove the syringe and leave for approx. 5 minutes. Leaktightness is
demonstrated if there is no pressure or volume loss. In order to speed
up this test procedure, the entire tube can also be temporarily
immersed in sterile water. The absence of ascending bubbles will
definitely indicate leaktightness.
Caution!
To prevent the cuff membrane from overstretching (herniation),
the maximum filling volume should not be exceeded (see table).
In order to prevent damage to the cuff, avoid using pointed objects
or cutting instruments during the leakage test.
After this procedure, completely evacuate the air from the cuff.
• Please also ensure that the fixation flange may be adjusted on the
shaft and that secure fixation to the tube shaft can be achieved by
arresting the fixaton screw. The area of the tube shaft where the
fixation flange is to be secured must not be wetted with lubricants,
grease or oil. If necessary, clean briefly with ethyl alcohol.
• Insert the introducer into the tube until it fits tightly in the tube and
the olive tip projects beyond the end of the tube.
Caution
Transport damage or incorrect storage may cause damage to the cuff
and other tube components. Never use damaged tubes and leaky cuffs!
3.
Inserting the tracheostomy tube
• Intubate the patient following currently accepted medical techniques
noting the specific "Warnings and precautions" in these instructions
for use.
• The introducer must be held in fixed position throughout the entire
procedure. After introducing the tube into the trachea and positioning
it correctly, the introducer should be removed. When removing the
introducer, the tracheostomy tube must be held in position.
Note
The intubation process can be facilitated by prior wetting of the insertion
aid and tube tips with a small amount of a water-soluble lubricant.
Caution
When using cannulas with cuff please ensure that the cuff is not
inadvertently damaged by sharp-edged objects during intubation.
To avoid subsequent injury to cartilage, the tube should be in the
tracheal opening without tension.