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increase the cuff pressure and may damage the trachea.
•
During mechanical ventilation and frequent changes of
the patient's position or manipulation of the tube, the inner cannu-
la may become separated from the outer cannula.
•
With the use of high ventilation pressures, leakage be-
tween the inner and outer cannulas may occur in isolated cases.
•
The use of tracheostomy tubes can lead to pressure
points, necrosis of the skin on the neck and skin irritation (e.g.
moisture). To avoid this, we recommend placing a pad under-
neath the neck flange.
•
To avoid damage to the material, the cuff should not be in
contact with lidocaine-containing aerosols or any ointments.
•
All components of the cuff inflation system must be kink-
free and not taut when testing the cuff pressure. The hand-held
manometer may otherwise give a false pressure reading.
•
Thin cuffs are to some extent permeable to water va-
pour. Therefore, condensate may accumulate in the cuff. Where
quantities are small, this is of no significance. However, if larg-
er quantities of condensate are inadvertently aspirated into the
inflation line, it is no longer possible to measure and adjust the
cuff pressure correctly and the tube needs to be replaced. Before
removing the tube, remove as much air or water from the cuff as
possible with a syringe.
•
When using together with other medical devices, observe the
respective instructions for use. If in doubt, contact the manufacturer.
6.
Warnings
•
Do not use if the sterile packaging is not intact.
•
The atraumatic inserter supplied with the tracheostomy
tube must be used only for the corresponding tube of the appro-
priate size. The size is clearly marked on the inserter.
•
Never use fenestrated inner cannulas for ventilation.
•
Use the occlusion cap only with fenestrated tubes (outer +
inner cannula) and an unblocked cuff.
•
Do not use a speaking valve during sleep.
•
When using laser or electrosurgical treatment equipment,
ensure that the tracheostomy tube is at a safe distance. There is
a risk of fire and toxic gases and the tube may get damaged.
•
Select the correct tube to ensure that the fenestration
(if applicable) is positioned at sufficient distance from the stoma
canal. Failure to do so exposes ventilated patients to the risk of
emphysema. Granulation tissue may also form or airway resist-
ance may increase if speaking valves or occlusion caps are used.
•
If a fenestrated tube is used, there is a risk of increased
formation of granulation tissue.
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