Patient Workbook & Guide: FastTract Procedure - Fast Tract™ Procedure

Transtracheal Oxygen Therapy Following the Fast Tract™ Procedure

• Cleaning in Place Instructions
• Removal for Cleaning and Reinsertion Instructions
• The SCOOP Oxygen Hose
• Serious Symptoms
• The Ten SCOOP Rules

Why is it important to clean and maintain your SCOOP catheter?

Keeping your catheter clean and functioning properly will allow you to enjoy all the benefits of your SCOOP catheter. In some patients, mucus may accumulate around the catheter tip just behind the opening. This is especially true during the first 10 to 14 days following the procedure. These accumulations are called “mucus balls” and can cause you to cough, wheeze or be more short of breath than usual. You will be taught how to clean your catheter in place after it is first inserted. During those first 2 weeks, you will return to your doctor several times to have your catheter stripped over a wire guide to clean the catheter and help prevent mucus balls. If you think you may be having problems with mucus balls, call your doctor, respiratory therapist or nurse. They may ask you to come in to get your catheter “stripped” over a wire guide. Your doctor may prescribe medications to help thin and loosen your mucus. Mucus balls are preventable in most cases and treatable in all. They are generally limited to the 10 to 14 days of Phase III, when the catheter is left in place. They are rarely a problem when you advance to Phase IV and begin removing and reinserting your catheter for cleaning.

Once your tract is healed (mature) your physician, respiratory therapist or nurse will help you determine which cleaning regimen will work best for you. Proper catheter care involves both cleaning in place and periodic removal for cleaning. You will be taught both techniques. Cleaning routines are customized for each patient. If you are using low flows of oxygen (2 liters per minute or less), you may elect to clean your catheter in place most of the time and remove it only periodically for cleaning. Through experience, most patients find the cleaning regimen that works best for them.

Instructions for Cleaning Your SCOOP Catheter in Place

Regular cleaning of your SCOOP catheter using the “in place” method will ensure proper functioning while the tract is healing (Phase III). Cleaning twice daily is recommended; however, your doctor may tell you to clean your catheter more often. Always use nasal prongs when cleaning your SCOOP catheter.

Review all steps before you begin

1. Gather all your cleaning supplies and position yourself near a sink and mirror with good light.
2. Wash your hands with soap and warm water.
3. Using a cotton swab (Q-Tip) and water, clean mucus crusts from skin around the catheter. If soap is necessary, use an antibacterial soap and rinse the soap residue off the skin. Do not use creams or ointments around the tract opening. Blot the area dry with tissues.
4. Wash the cleaning rod with antibacterial soap, and rinse well to remove all soap residue.
5. Disconnect the catheter from the SCOOP oxygen hose and squirt 2.0 cc’s of saline into the catheter. The squirts may cause coughing.
6. Run the cleaning rod down the inside of the catheter 3 times, all the way down until the handle prevents it from going any further.
7. Squirt 2 more cc’s of saline down the catheter. Reconnect the SCOOP oxygen hose to the catheter.
8. Wash and store the cleaning rod in a clean, dry place. Remember not to stretch the rod but just pat it dry.
9. Place a 2x2 or 4x4 gauze under the flange if necessary.
10. Place strips of plastic, paper tape or Op-Site on both sides of the SCOOP flange, over the bead chain necklace for added security. This is especially important at night and is normally done only during Phase III of the program.

Instructions for Removal and Reinsertion of Your SCOOP Catheter

It is recommended that you only remove and reinsert your catheter 2 times per day. If additional cleaning is necessary, your doctor may advise you to combine catheter removal and reinsertion with cleaning in place. Removal and reinsertion requires a clean second catheter. Use nasal oxygen at all times when removing and reinserting your SCOOP catheter.

Review all steps before you begin

1. Gather your cleaning supplies, including a second SCOOP catheter, and position yourself near a sink and mirror with good lighting.
2. Wash your hands with soap and warm water.
3. Using a cotton swab (Q-Tip) and water, clean mucus crusts from the skin around the catheter. If soap is necessary, use an antibacterial soap and rinse all the residue off the skin. Do not use creams or ointments around the tract opening.
4. Apply a small amount of water soluble jelly (i.e. K-Y Jelly) to the tip of the clean catheter.
5. Disconnect the bead chain necklace and SCOOP hose from the catheter. Remove the first catheter from the tract opening. The catheter should only be out momentarily.
6. Insert the clean catheter. Place the tip into the tract opening and gently push the catheter straight back. If resistance is met, twirl the catheter as it is inserted. Do not try to direct the catheter downward...it will direct itself. It is normal to experience a tickle cough as the catheter enters the trachea. If you cannot insert the catheter within 5 minutes, call your doctor immediately and put your nasal cannula back on, at your prescribed flow rate.
7. Reconnect the bead chain necklace. When properly inserted, the SCOOP label on the catheter flange will be upright and readable.
8. Reconnect the SCOOP oxygen hose. The exchange procedure is now complete.
9. Clean the soiled catheter. Start by cleaning all the mucus from the catheter tip with plain warm water. Use an antibacterial soap, such as Hibiclens, and water to disinfect the catheter. Run the cleaning rod through the inside of the catheter several times. Rinse the catheter, outside and inside, thoroughly to remove all soap residue, and blot the catheter dry with a paper towel. Do not boil the catheter or place it in extremely hot water (over 120o F). If the water is too hot for your hands, it’s too hot for the catheter. Do not soak the catheter in any disinfecting solution.
10. Store the clean SCOOP catheter and cleaning rod in its original package in a clean, dry place, out of direct sunlight.

Replace your SCOOP catheters and hose routinely every 90 days. Longer use of the catheter may result in the catheter becoming stiff or brittle. This can lead to chronic tract discomfort. The catheter should be replaced immediately if the catheter develops visible cracks, breaks, permanent kinks or foul odor.

The SCOOP Oxygen Hose

An oxygen hose has been specially designed to provide you with maximum comfort and safety. A security clip connects the hose to your clothing. The clip provides safety from tugging and pulling on your catheter, and it is designed to be worn on the right side. The SCOOP hose is required to properly attach your SCOOP catheter to your oxygen source. The upper segment of the SCOOP oxygen hose should be worn under your shirt, blouse, sweater, etc. This helps to provide a more secure connection between the SCOOP oxygen hose and the SCOOP catheter, and improved comfort and convenience. There are 9 different size hose combinations to accommodate all sizes of patients.

Hose Fitting

The hose length is measured in 2 segments. The upper length is measured from the hub of the catheter to the right hip. The lower length is measured from the hip to the portable oxygen source placed on the floor next to you. The lower length should drape just a few inches off the floor.

Instructions

1. Attach the suspender clip to the top of your pants, shorts, skirt or pajama bottoms on the right side.
2. Run the hose under your shirt, blouse, t-shirt or pajama top.
3. Insert the small male connector on the end of the hose into the female connector on the SCOOP catheter.
4. Connect the large end of the oxygen hose to your oxygen supply. Be sure that all connections fit tightly and are secure. If they are not, check with your doctor or homecare dealer.
5. Replace your SCOOP hose every 90 days or immediately if it becomes cracked, kinked, broken or develops a bad odor.