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Instructions
For more information, techniques and frequently
asked questions, go to www.safe-seal.net
The safe-seal endo tube is easy to use and extremely safe. It
removes almost all of the dangers of an inflation cuff tube and
provides several advantages. Here are some helpful tips:
1. A stylet is very helpful when inserting the tube. The
flexibility of the tube is an extreme advantage, eliminating
tracheal trauma by rotation of the tube during anesthetic. The
patient can even be rotated without disconnecting the tube from the
anesthetic machine. The soft, flexible baffles will simply rotate,
causing no undo pressure on the tracheal mucosa.
2. The tube should be inserted in the normal fashion and stopped
while inserting in a forward motion. This allows the baffles to
lean rostrally thus allowing an “o” ring effect to seal the trachea
during inspiration. In this position the baffles are designed to
allow bypass of excess pressure in the lungs, more than 20-30
centimeters of water. If more pressure is desired by the operator
for artificial respiration, the tube is simply pulled back ½ inch
and the baffles will flip over and allow as much pressure to be
applied as the operator deems safe.
3. It should be noted that when a patient is first intubated and
is “light” that the patient may forcefully cough or expire and
sounds of air leakage around the tube may be heard. This is normal
and is due to the fact that excess pressure is allowed to bypass the
tube. No leakage should occur after the patient is breathing
easily.
4. When inserting the tube, lubricating the baffles with water or
lubricating gel my be helpful but is usually not necessary. If a
smaller patient is to be intubated and the tube is marginally tight,
lubrication is beneficial.
5. The operator should be aware that the body weight of the
patient is not the only factor in determining the size of the tube
to be used. The safe-seal tube will fit a larger range of tracheal
sizes than traditional inflation cuff tubes. However, there are
breeds of dogs whose tracheas are either larger or smaller than
their weight would suggest. Rottweilers for instance have a small
trachea for their weight. A 3/8 inch tube will usually fit a large
Rottweiler quite comfortably. The simple rule is if the tube seems
tight while inserting, simply use the next smaller tube.
6. Kinking or bending of the tube is possible if extreme
right-angle pressure is applied to the tube, similar to standard
inflation cuff tubes used today. This is prevented by securing the
mouth piece to the snout in the usual fashion, with the flared
portion of the mouth piece next to the front teeth. On the smaller
tubes, the tip of the tube is more flexible than the shaft. But
when inserted properly, it is safely inside the trachea and is not
subjected to kinking or bending. For this reason the small, ¼ inch
tube should be inserted until the coned portion of the tube, where
the shaft meets the smaller tip, is in contact with the opening of
the larynx.
7. To withdraw the safe-seal tube, simply detach from the snout
and remove. Unlike traditional tubes, it is not necessary to tilt
the patient’s head and neck downward to prevent aspiration of fluids
which may have accumulated proximal to the cuff of the tube. The
safe-seal tube will “squeegee” the trachea clean.
8. When using a relatively small tube in a very large patient, if
air leakage is detected, simply move the tube forward or backward ½
inch to reposition the baffles and the tube should seal. If not,
use the next larger tube.
For more information, techniques and frequently asked questions, go
to www.safe-seal.net
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