Tracoe Comfort Instructions D'utilisation page 5

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Speaking tubes have small perforations in the outer cannula. The
corresponding inner cannulas have matching bigger openings. The
openings, which are positioned over each other, allow the exhaled air
to flow into the upper airways.
In order to improve the phonation, the TRACOE comfort plus speaking
tube has two additional holes in the inner arch in addition to the fenes-
tration in the outer arch of the tube.
The small perforations of the outer tubes are too small for inserting a
suction catheter, and this is a deliberate design in order to prevent
injuries to the tracheal mucosa.
3. Intended Use
TRACOE comfort tubes stabilise the tracheostoma of a tracheostom-
ised or laryngectomised patient and keep it open.
The initial selection of the tube and insertion of the TRACOE products
must be carried out by a physician or by other qualified trained person-
nel. The users must be trained by qualified personnel in handling the
products, and especially in the functioning and handling of speaking
tubes and valves.
Depending on the physique and anatomy of the patient, the
TRACOE comfort tubes or slightly longer TRACOE comfort plus tubes
are used.
The extra-long TRACOE comfort tubes are used, in particular, for
tracheomalacia or tracheal stenoses that are located deeper inside
the trachea.
Caution: A check by a physician at regular intervals is required, espe-
cially if the patient has a tendency to crust formation and granulation
tissue formation and/or heavy secretion.
4. Contraindications
CAUTION: Tubes with a speaking valve must not be used for laryngec-
tomised patients because these patients cannot exhale the inhaled air,
and there is a risk of asphyxiation.
The TRACOE comfort tubes are only suitable for ventilation subject to
certain conditions because they have no cuff and the locking of the
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inner cannula to the 15 mm connector cannot reliably ensure that the
inner cannula is not dislocated. Therefore, if ventilation is required, the
tube should be changed to a suitable tube such as the TRACOE twist
or TRACOE twist plus.
TRACOE comfort tubes do not show on X-ray images because they do
not have an X-Ray contrast line.
5. Tubes with a Speaking Valve
The tubes with a speaking valve are used for patients with a fully or
partially intact larynx and allow the patient to speak. The inhalation
is done via the tracheostomy tube. During exhalation, the speaking
valve closes and routes the air through the natural airways. This way, a
patient with an intact anatomy will be able to speak. It is important that
the patient's upper airways are entirely unobstructed.
TRACOE comfort speaking tubes are fenestrated and have a
speaking valve of type A or B.
TRACOE comfort tubes with a speaking valve type A have a flap
support made of silver. The flap support can be removed from the
inner cannula by pushing it outwards. For the TRACOE comfort tubes
with a speaking valve type B, the valve support can be rotated. This
mechanism allows free access to the inner lumen of the tube for both
valve types, for example for sucking out tracheal secretion.
CAUTION: A physician should decide for each individual patient if a
speaking valve can be inserted.
CAUTION: Patients who are unable to exhale on their own, must not
use a speaking valve because of the acute risk of asphyxiation.
If the patient requires additional oxygen, the product variants with an
oxygen connection can be used.
For long periods without speaking or at night, an inner cannula with a
15-mm connector or 22 mm adapter can be used, onto which a heat
and moisture exchanger can be placed. The consistent use of a heat
and moisture exchanger can significantly reduce crust forming.
EN
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