4
15
Confirm free movement of the guide wire within the
Tracheostomy tube.
16
Remove the indwelling Tracheostomy tube and, to help ensure
that the guide wire is not damaged, anchor the free end of
the guide wire with forefinger and thumb, advance the new
Tracheostomy tube over the guide wire into the trachea.
17
Remove the obturator and guide wire leaving the
Tracheostomy tube in place, and secure the Tracheostomy
tube with the Portex® Tracheostomy tube holder
(100/503/200) provided.
18
Following Tracheostomy tube change it is advisable to suction
the trachea and Tracheostomy tube to establish that the airway
remains clear. Any bleeding caused by the tube change could
lead to clot formation in the airway producing severe airway
obstruction.
REPLACING THE INNER CANNULA:
1
Disconnect the tracheostomy tube from the breathing system
2
Remove the old inner cannula
3
Insert a new or spare inner cannula
4
Reconnect the breathing system and check for security
5
Clean or discard the old inner cannula
INNER CANNULA
CLEANING INSTRUCTIONS:
Daily cleaning of the inner cannula is recommended or
whenever the inner cannula becomes contaminated by mucus
or secretions. This period of time will vary according to the
individual patient’s needs.
Always remove the inner cannula from the Tracheostomy tube
for cleaning.
1
Soak the inner cannula in sterile saline or mild detergent
solution for up to 15 minutes.
2
Agitate the inner cannula in the solution to loosen any
secretions. Using the cleaning brush provided to help remove
any dried or sticky secretions.
3
After soaking and cleaning rinse the inner cannula and
cleaning brush with fresh sterile saline solution.
4
Allow to dry naturally. Once the inner cannula is clean and
dry it should be stored clean and dry and free from
particulate matter.
TRACHEOSTOMY TUBE
CLEANING INSTRUCTIONS:
The Tracheostomy tube should only be cleaned with a sterile
saline solution.
PRECAUTIONS:
1
The security of all breathing system connectors should
be checked when the circuit is established and frequently
thereafter. Disconnection may be facilitated with the use of a
disconnection wedge (100/555/000).
2
Patients should be adequately humidified (e.g. using the
Portex® Thermovent® HEPA+ 100/586/000 or Portex®
Thermovent® T 100/570/015) to minimise encrustation of the
Tracheostomy tube and/or inner cannula lumen and prevent
mucosal damage.
3
The patency of the Tracheostomy tube lumen must be assured
by regular suctioning and regular cleaning of the inner cannula
(if one is used). Check routinely and replace as required to
maintain a patent airway. Maximum recommended period of
use 30 days.
4
Cuff pressure and volume should be monitored, adjusted a
nd recorded routinely so that damaging overinflation does
not occur.
5
Devices used in or during inflation of the cuff must be clean
and free from all foreign matter. The inflation device should be
removed from the inflation valve immediately after use, and
the dust cap fitted. Test inflate the cuff before insertion.
6
Guard against cuff damage by avoiding contact with sharp edges.
7
The inflation line valve may interfere with Magnetic Resonance
Imaging (MRI) picture clarity. Ensure the valve is positioned
away from the area being scanned.
8
Care should be taken to ensure that the inner cannulae do
not become kinked or damaged during cleaning, and that no
kinked or damaged inner cannulae are re-inserted into the
Tracheostomy tube.
9
Following insertion, verify the tube position and the location of
the fenestra, for example by means of a chest X-ray.
10
The position and patency of the fenestration in the Portex®
Fenestrated Tracheostomy tube and inner cannulae should
be checked immediately after insertion to determine optimal
position of the fenestra, and frequently thereafter to ensure
that tissue granulation has not caused an obstruction.
11
If Portex® Tracheostomy tubes are used outside the hospital, the
patient must be instructed by a healthcare professional in the
safe use and handling of the product. A patient care booklet is
also available from Smiths Medical Customer Services.
12
Do not use solutions other than those indicated in the cleaning
instructions to clean any part of this Tracheostomy tube.
13
Do not use any abrasive cleaning implements to clean the
inner cannula. Use only the cleaning brush provided. Do not
use this brush to clean the tracheostomy tube.
14
Blue Line Ultra® Tracheostomy Tubes and Inner Cannula are
designed and intended for single patient use. They should
not be re-sterilised by any method.
15
Repositioning of the
in-situ
tracheostomy tube while the cuff is
inflated should be avoided.
Uncontrolled
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