Pulmodyne Blom Manual Del Usuario página 3

USE OF THE BLOM TRACHEOSTOMY TUBE AND BLOM STANDARD CANNULA
Preparation
1. Selection of the appropriate device size is left to the discretion of the physician.
Note: With morbidly obese patients or patients with neck edema, the skin to
trachea distance may render the Tracheostomy Tube too short, preventing
ventilation of the patient.
2. Remove the contents from the package.
3. Verify the Tracheostomy Tube function and integrity. Check that the Standard
Cannula can be inserted and removed and is not damaged. Check that the Obturator
can be inserted and removed and is not damaged.
If using the Fenestrated Cuffed Tracheostomy Tube:
4. Check the integrity of the cuff by inflating and deflating it prior to insertion.
5. Lubricate with a water soluble lubricant, by applying it to the Tracheostomy Tube and
Obturator. Ensure that the lubricant does not occlude the lumen or fenestration of the
tube and prevent patient ventilation.
Insertion
1. Suction the patient before insertion.
2. With the Obturator, in place, insert the Tracheostomy Tube through the stoma in
accordance with currently accepted medical techniques.
3. Verify tube position by brochoscopic view or chest X-ray to ensure correct placement.
Incorrect placement could result in trauma to the trachea or respiratory obstruction.
If using the Fenestrated Cuffed Tracheostomy Tube:
4. Using a syringe inflate the cuff
Warning:
• Cuff pressure should be monitored
• If used during anesthesia, nitrous oxide may change the cuff inflation.
Verify cuff volume periodically.
• Cuff should not be inflated with a measured volume of air
• Avoid repositioning of the tube with the cuff inflated
• Prior to removal, deflate the cuff fully
5. Secure the Tracheostomy Tube with SoftTouch Tube Holder, Twill Tube Holder or
other Tracheostomy Tube securing device. Ensure the tube is properly positioned.
6. Insert the Standard Cannula. Verify that the Standard Cannula has been securely
fastened.
Warning:
• The Standard Cannula is designed to be used only in conjunction with the
Blom Tracheostomy Tube.
• The Standard Cannula is available in four sizes: #4, 6, 8, 10 and should only
be used with the equivalent size Blom Tracheostomy Tube.
• Make sure the correct size has been selected. If the Standard Cannula
is too long, it may protrude from the Tracheostomy Tube causing
tracheal damage or occlusion. If it is too short, it may lead to a buildup
of secretions that can cause infection and/or airway obstruction.
Additionally, insertion of an incorrect size inner cannula can result
in inadequate ventilation due to leakage.
• Inner cannulas should be routinely checked or replaced at regular
intervals to avoid blockage causing reduced lumen diameter and
increased respiratory effort.
• Do not lubricate the inner cannula as lubricant may occlude the inner
lumen causing airway obstruction. This may also prevent the inner
cannula from being retained in the Tracheostomy Tube.
• The Tracheostomy Tube should always be used with an inner cannula
in place unless the Decannulation Plug is being used.
7. If the patient requires ventilator support, a swivel adapter may be utilized to
reduce stress on the tube. Reconnect all adapters and the ventilator circuit.
USE OF THE BLOM SUBGLOTTIC SUCTIONING CANNULA
Intended Use
The Subglottic Suctioning Cannula is designed to be used only in conjunction with the
Blom Fenestrated Cuffed Tracheostomy Tube. Located on the exterior surface of the
cannula is a separate lumen which can be connnected to intermittent or continuous
suction. The Subglottic Suctioning Cannula is intended for the evacuation of secretions
situated above the Tracheostomy Tube cuff.
Blom Subglottic Suctioning Cannula Directions for Use
1. The Subglottic Suctioning Cannula is available in four sizes: #4, 6, 8, 10 and should
only be used with the equivalent size Blom Fenestrated Cuffed Tracheostomy Tube.
2. Select the appropriate size Subglottic Suctioning Cannula.
3. Suction the patient (if required) prior to removing the existing inner cannula and
inserting the Subglottic Suctioning Cannula.
4. Disconnect any device tubing and adapters connected to the hub of the existing inner
cannula and slowly remove the cannula from the Tracheostomy Tube.
5. Insert the Subglottic Suctioning Cannula into the Tracheostomy Tube. Verify that it
has been securely fastened.
6. Reconnect any device tubing and adapters and insure proper functionality.
7. Connect the subglottic suction line to suction tubing and regulator. Insure the thumb
port valve is closed. Select intermittent or continuous suction and set the vacuum
level appropriately -- continuous low pressure suction should not exceed 20-30
mmHg. Intermittent suction should be 100-150 mmHg.
8. Routinely monitor the suction lumen by visual inspection. Absence of secretions
may indicate that no subglottic secretions are present or that the suction port has
become occluded. If blockage is suspected, the Subglottic Suctioning Cannula can
be removed and replaced with a new Subglottic Suctioning Cannula. Alternately, the
removed occluded cannula can be flushed with sterile water or saline and then re-
inserted.
9. All inner cannulas should be routinely checked or replaced at regular intervals to
avoid blockage causing reduced lumen diameter and increased respiratory effort
Warning: Never place saline or other liquids directly into the suction lumen
while the Subglottic Suctioning Cannula is in the patient.
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