25
EN
2. Removing the tube
CAUTION!
Accessories such as a tracheostoma valve or HME (Heat Moisture Exchanger) must be
removed first before proceeding to remove the Fahl
®
tracheostomy tube.
CAUTION!
If the tracheostoma is unstable, or in emergency situations (puncture/dilation
tracheostomy), the tracheostoma can collapse after withdrawal of the tracheostomy
tube, thereby impairing air supply. A fresh tracheostomy tube must be kept ready for use
in such cases and must be quickly inserted if necessary. A tracheal dilator (REF 35500)
can be used for temporarily securing the air supply.
The cuff must be emptied before removing the tracheostomy tube. The head should be
tilted back slightly for removal of the tube.
CAUTION!
Never use a cuff pressure gauge to empty the low-pressure cuff. Always use a syringe
for this.
Before the air is removed from the balloon by means of a syringe and the tracheostomy tube is
withdrawn, the region of the trachea above the balloon must first be cleaned by suctioning off
secretions and mucus. If the patient is responsive and reflexes are intact, it is recommended that
the patient be suctioned while at the same time unblocking the tracheostomy tube. Suctioning is
performed by inserting a suction catheter through the cannula tube into the trachea. In this way,
suctioning can be performed without any problems and gently for the patient and cough stimulus
and the risk of aspiration are minimised.
Next, deflate the low pressure cuff while suctioning off at same time.
If secretions are present, these are now taken up by the suction tube and can no longer
be aspirated. Please note that the tracheostomy tube must in every case be cleaned,
if necessary disinfected, and lubricated with stoma oil as specified below prior to
reinsertion.
Proceed very carefully to avoid injury to the mucus membranes.
The tube must always be cleaned and, if necessary, disinfected as follows before re-inserting
according to the instructions provided below.
Step-by-step instructions to remove the Fahl
®
tracheostomy tubes:
The tracheostomy tubes should be removed with the head slightly tilted back. Grip the tube at
the side by the neck flange or the housing (see picture 7).
Carefully remove the tracheostomy tubes.
The outer cannula (if an inflated low-pressure cuff is present) remains in the tracheostoma.
When removing the inner cannula, the following must be observed: The connection between
inner and outer cannula must first be released by slight counterclockwise rotation (in inserted
condition from the patient's point of view).
Reinsertion of the inner cannula is performed in reverse sequence as described above.
IX. CLEANING AND DISINFECTION
CAUTION!
For reasons of hygiene and to avoid the risk of infection, you should thoroughly clean
the Fahl
®
tracheostomy tube at least twice a day, more often during heavier secretion
production.
In case of an unstable tracheostoma, the airways must always be secured before
removing the tracheostomy tube and a replacement tube must be kept ready for
insertion. The replacement tube must be inserted immediately, even before cleaning and
disinfecting the changed tube.
CAUTION!
the tracheostomy tubes must not be cleaned using a dishwasher, a steam cooker, a
microwave oven, a washing machine or similar appliances!
Keep this in mind, your personal cleaning schedule, including additional disinfection if required,
must always be determined in consultation with your doctor/physician and according to your
individual needs.
