Covidien Shiley Série Mode D'emploi page 7

Tube Preparation and Insertion Using the Obturator or a Percutaneous Loading Dilator
The tube sizes that have a compatible loading dilator available (reference page 2) can be used in
percutaneous dilatational tracheotomy (PDT) procedures.
NOTE: As this tracheostomy tube can be placed percutaneously, sterile technique should be
followed for the handling and placement of the tracheostomy tube.
1. Insert the obturator or compatible loading dilator into the tracheostomy tube.
• If using the obturator, ensure it is fully seated. If indicated to ease insertion, apply a thin film
of water soluble lubricant to the outside of the tracheostomy tube and protruding portion of
the obturator.
• If using a loading dilator for a PDT procedure, generously lubricate the surface of the
appropriately sized loading dilator and load the tracheostomy tube onto the dilator. Ensure
that the tapered section of the loading dilator clears the distal tip of the tracheostomy tube by
approximately 2 cm.
NOTE: The loading dilator is available separately.
2. If using a guide wire with the obturator, first insert the guide wire in the patient, then thread it all
the way through the obturator, starting at the distal tip of the obturator.
WARNING
If the guide wire is damaged during the procedure, it may be difficult to continue insertion
without trauma to the trachea and misplacement of the tracheostomy tube. In these cases, it
may be possible to continue only if:
a. the damaged section can be advanced into the trachea, and
b. there is a sufficient length of undamaged guide wire remaining.
If the guide wire cannot be salvaged, use a new guide wire.
3. Insert the tube into the patient's trachea.
4. After the tube is properly in place, remove the loading dilator or obturator and guide wire
(if used) immediately.
5. Insert the disposable inner cannula into the tracheostomy tube and press to lock into position.
Tube Removal
1. Remove the neck strap from around the patient's neck.
2. While holding on to the tracheostomy tube's 15 mm connector, gently twist and pull the
breathing circuit connector to disconnect the circuit from the tracheostomy tube.
3. Slowly remove the tracheostomy tube from the patient.
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