Use of gloves, protective eye wear, and a respiratory face mask is
recommended for the following procedure.
The Indwelling Occluder and its accessories should always be
thoroughly clean and dry to help avoid introducing contaminants
into the tracheostoma, TE puncture, or esophagus.
Note: Insertion or removal of the device in the TE puncture
should only be done with a bright light focused directly on the
stoma.
Have the following Blom-Singer items prepared for aseptic
insertion of the device:
• Blom-Singer Indwelling Occluder
• Blom-Singer Gel Cap Insertion System
• Blom-Singer Dilator-Sizer
• Blom-Singer Voice Prosthesis Sizer (or Dilator-Sizer)
• Blom-Singer Puncture Dilator (or Dilator-Sizer)
• Blom-Singer Prosthesis Inserter
Dilate and Measure
Please refer to the Blom-Singer Dilation/Sizing System Instructions
For Use for complete product details.
Optional: The Blom-Singer Sizer or Puncture Dilator may be used
as an alternate procedure. Refer to the instructions for use supplied
with the product.
1. Dilate the TEP with a Blom-Singer Dilator-Sizer of the
appropriate diameter. Gently insert the Dilator-Sizer into the
puncture completely to the neck strap (diagram 2) and leave in
place for five minutes.
2. Carefully withdraw the Dilator-Sizer until very gentle
resistance is detected indicating that the esophageal wings are
seated against the anterior wall of the esophagus (diagram 2a).
Note: Pulling too firmly on the Dilator-Sizer may squeeze or
compress the TE tract resulting in an erroneous measurement
that indicates it is shorter than it actually is.
3. Note the marker that is closest to the entrance of the TE
puncture. Read the size number on the Dilator-Sizer and select
a Blom-Singer Indwelling Occluder of corresponding size. If the
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