Covidien Shiley Gebrauchsanweisung Seite 7

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 reusable inner cannula into the tracheostomy tube by squeezing the proximal end of
the inner cannula and lightly pressing the end of the inner cannula to lock into position.
6. Clean the obturator and store it in an accessible location near the patient in case it is needed
for an unscheduled re-insertion.
Inner Cannula Cleaning
1. Remove the existing reusable inner cannula from the tracheostomy tube by squeezing the
end of the inner cannula and slowly withdrawing it.
2. Clean the removed inner cannula as described in the "Cleaning" section.
3. Insert the cleaned inner cannula into the tracheostomy tube by squeezing the proximal end
of the inner cannula and lightly pressing the end of the inner cannula to lock into position.
4. Routinely evaluate the patient's respiration and vital signs after locking the inner cannula
in the tube.
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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