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The inner cannulas can easily be removed from the outer cannula, thus allowing the air
supply to be increased quickly if necessary (for instance in case of dyspnoea).
In the case of the silver tracheostomy tubes, the inner cannulas are held in place in the
EN
outer cannula by means of a lever. To remove the inner cannula, this lever must be turned
sideways.
Inner cannulas must never be used without outer cannula but must always be affixed to the
outer cannula.
4.1 Speaking valves
Tracheostomy tubes with speaking valve (LINGO/PHON) are used after tracheotomy with a
complete or partially retained larynx and enable the user to speak.
In tracheostomy tubes with silver speaking valve, the speaking valve can be detached
from the inner cannula by pushing it out.
VIII. DIRECTIONS FOR TUBE INSERTION AND REMOVAL
For the Doctor/Physician
The appropriate tracheostomy tube must be selected by a doctor/physician or trained me-
dical professionals.
Select a tube that fits the patient's anatomy to optimise comfort and ventilation (breathing
in and out).
The inner cannula can be removed at any time to increase air supply or for cleaning. this
can for instance be necessary if the cannula is clogged up with secretion residues which
cannot be removed by coughing or because no equipment for suctioning off the secretions
is available.
For the Patient
It is advisable to use sterile disposable gloves.
Carefully examine the tube before first use to make sure that it is not damaged and that
there are no loose parts.
Should you notice any anomaly or anything unusual, DO not use the tube. return the tube to
the manufacturer for inspection.
Tracheostomy tubes must be cleaned thoroughly every time before being inserted. Cleaning
is also recommended prior to first use if the tracheostomy tube is not supplied as a sterile
product!
The tube must always be cleaned and, if necessary, disinfected as follows before re-inser-
ting according to the instructions provided below.
If secretion collects in the lumen of the Fahl
tracheostomy tube or stoma button and cannot
®
be removed by coughing or aspiration, the tube should be removed and cleaned.
After cleaning and/or disinfection, carefully examine the Fahl
tracheostomy tube for sharp
®
edges, cracks, or other signs of damage, since these may impair function and/or injure the
mucus membranes in the airways.
Never under any circumstances continue using damaged tracheostomy tubes.
1. Insertion of the tube
Step-by-step instructions to insert Fahl
tracheostomy tubes.
®
Before application the users should clean their hands (see picture 3).
Remove tube from the package (see picture 4).
If an obturator is to be used, this must first be fully inserted into the cannula tube so that the
collar on the gripping piece of the obturator comes into contact with the outer edge of the 15
mm connector and the tip of the olive projects beyond the tip of the cannula (proximal end of
cannula). The obturator must be held in this position during the entire procedure.
Next, push a tracheal compress onto the tracheostomy tube.
To facilitate insertion of the tracheostomy tube, it is advisable to lubricate the outer tube by
wiping it with an OPTIFLUID
stoma oil wipe (REF 31550) which allows the stoma oil to be
®
applied evenly to the whole surface of the tube (see picture 4a and 4b).
If you are inserting the tube yourself, use a mirror to make insertion of the Fahl
tracheo-
®
stomy tube easier.
When inserting the Fahl
tracheostomy tube, hold it by the neck flange with one hand (see
®
picture 5).
Pull the tracheostoma slightly apart with your free hand to allow the tip of the tube to fit into
the tracheostoma more easily.
15

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