Publicité
Les langues disponibles
Les langues disponibles
EN
•
The cuff pressure can change, for example due to alti-
tude changes (e.g. in an aircraft), or if laughing gas is used as
an anaesthetic or during the connection and disconnection of a
hand-held manometer.
•
Excessive cuff pressure poses a risk of permanent dam-
age to the trachea.
•
Excessive cuff pressure may give rise to cuff hernias.
•
Insufficient cuff pressure poses a risk of aspiration.
•
Ensure that the correct Luer connectors are used
(e.g. 2a + 9).
•
During insertion and removal of the tube, irritation,
need to cough or bleeding may occur.
7.
Adverse Reactions
Pressure points, necrosis, skin irritation, granulation tissue, need
to cough, difficulty swallowing, and bleeding.
8.
Inserting the Tube
8.1
Preparing the Tube
For the first percutaneous dilation tracheostomy, always keep an
identical twist set at hand as a replacement.
Carry out the following steps under sterile conditions.
1.
Check the pack content for completeness (D).
2.
Check the cuff (2) for leakage by inflating it. For this pur-
pose, inflate the cuff with a hand-held manometer to a pressure of
50 cmH
O (≈ 36.78 mmHg) and wait for 1 minute to see whether
2
the cuff deflates. If the cuff is leak-tight, remove all air from the
cuff with a syringe. Push the cuff upwards in the direction of the
neck flange (5) to facilitate insertion.
3.
Before using the tracheostomy tube, check that
•
the folding silicone sleeve at the distal end of the inserter fits
seamlessly with the distal end of the tracheostomy tube
•
the guidewire passes freely through the guiding catheter.
4.
To facilitate insertion, apply a pea-sized amount of the en-
closed lubricating gel to the inserter and the tracheostomy tube.
8.2
Preparing the Patient
•
Ensure that the patient is well pre-oxygenated before
cannulation or recannulation.
•
The patient should be supine with a cushion under the
shoulders for the head and neck to be extended. The headrest of
the patient's bed should be raised by 30 to 40 degrees.
•
Sedate the patient and monitor the vital functions.
•
Should complications arise during or recannulation, take
appropriate safety measures (e.g. tracheal spreader, tube with
10
Publicité
