Covidien Shiley Instrucciones De Uso página 6

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13. Suction the patient to remove any accumulated secretions or blood
from the trachea.
14. Remove and discard** tracheal tube.
15. Centre and adjust the tube to the patient's anatomy, by using the fixed
or adjustable flange.
16. Secure the tracheostomy tube to the patient's neck by utilizing the
tape provided.
17. Verify final placement by auscultation and x-ray means.
18. Prior to extubation, remove accumulated secretions from above the
cuff. Deflate the cuff by inserting a syringe into the valve housing and
removing the air until a definite vacuum is noted in the syringe and the
pilot balloon is collapsed.
19. Extubate the patient using currently accepted medical techniques for
the removal of a tracheostomy tube.
20. Discard** tracheostomy tube.
When changing a tracheostomy tube, the appropriate steps described
above, where applicable, should be followed, in addition to currently
accepted medical techniques and safety precautions.
** When discarding a device, consideration should be given to the specific
WARNINGS/PRECAUTIONS (General) stated in the instruction insert.
ADDITIONAL SUGGESTED DIRECTIONS TO USE THE -
EVAC LUMEN:
• Suction secretions above the cuff using the minimum suction pressure
required to effectively remove the secretions. Continuous suction at
20 mmHG may be used. Intermittent suctioning using practices similar
to standard endotracheal suctioning may also be performed. Typically
these practices include suction at 100-150 mmHG for 10-15 seconds. If
blockage is suspected in the Evac lumen, a small amount of air may be
injected through the lumen to maintain its patency.
• Alternative methods of suctioning and maintenance of the subglottic
space and reduction of nosocomial infection are described in Smulders
K, et al. Chest. 2002; 121:858-862 and Mahul Ph, et al. Intensive Care
Medicine. 1992; 18:20-25.
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