CORTRAK : To Guide safer Feeding Tube Placement Guide

CORTRAK*: TO GUIDE SAFER FEEDING TUBE PL ACEMENT

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A single error at the time of nasogastric and/or nasoenteric tube placement may lead to complications. Clinicians insert small bore feeding tubes using various methods such as blind placement.1 • Blind insertion: The most common technique for nasoenteral placement, results in malposition in up to 16% of cases, with tracheal, pulmonary, or pleural malposition. This may result in pulmonary or pleural formula infusion, pneumothorax or pulmonary abscess.2

Did you know ? • Airway placement using a blind placement technique occurs in 1.2% to 1.8% of placement attempts.3 • Approximately, 1 in 3 of these misadventures result in pneumothorax and nearly half of these patients die from this complication.3

Electromagnetic guided placement can help overcome the challenges of conventional feeding tube placement and confirmation.4

Benefits of electromagnetic guided placement technique:

Zero oesophagus and lung placements5

Avoidance of lung placements by recognizing proximal pulmonary deviation5

Eliminates risk of pneumothorax (P = 0.009)3 Improves placement and success rates (83.9% success P<0.001) in high-risk patients3 Reduces cost5,6

Reduces need of X-rays6

Reduces time to tube placement and feeding5

Our Solution CORTRAK* placement system is a bedside technology that electromagnetically tracks the advancement of feeding tubes on a monitoring screen which allows evaluation of tube advancement in real time.3 CORTRAK* 2 EAS (Enteral Access System) helps qualified clinicians manage the placement of feeding tubes to support patient nutrition delivery by - 7 • Visualizing feeding tube placement at the bedside • Placing tubes and confirming placement per institution protocol • Minimizing and identifying misplaced tubes in conjunction with institution protocols CORTRAK* 2 EAS components include: 1. Monitor 8 2. Receiver Unit 8 3. Feeding tube with electromagnetic transmitting stylet 8 1 2. Receiver: Placed over the patient’s xiphoid process, to receive a signal from the stylet with the electromagnetic tip.8

1. Monitor: Location of the feeding tube tip placement is shown on the monitor’s screen in 1 of 4 quadrants corresponding with the patient’s anatomy.8

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3 3. Electromagnetic transmitter: The feeding tube contains a stylet with an electromagnetic transmitter at the distal tip.8

CORTRAK* 2 EAS screen views: CORTRAK* 2 EAS has three placement views for added support.7 Anterior View9

Depth Cross Section9

Lateral View9

Anterior View9

Depth Cross Section View9

Lateral View9

On-screen visualization at bedside supports qualified clinicians in placing feeding tubes, confirming placement per institution protocol and reducing secondary insertion attempts.7 Distinguishing gastric and lung placement: CORTRAK* provides an immediate visual indication that the tube is not in the correct place1

Advance tube through esophagus to stomach and small bowel per physician’s order.9

Continuously observe and assess both the patient and the tracing while advancing the tube to ensure proper insertion of the tube.9

Stomach

Small Bowel

If tube deviates from vertical midline, respiratory irritation or distress occurs, or resistance is met, STOP INSERTION and immediately withdraw tube. Re-assess the patient and notify physician per institution protocol.9

Choose CORTRAK* 2 EAS for timely and efficient nutrition delivery for your critically ill patients, efficient tube placement system to reduce hospital burden and improved short-term outcomes and long-term recovery for all patients.7 Contraindications For Use: DO NOT use the CORTRAK* 2 Enteral Access System for patients with implanted medical devices that may be affected by electromagnetic fields.9 *Institution protocols must always supersede the use of the CORTRAK*2. Clinical judgment must always take precedence.9 The CORTRAK* 2 is not intended to replace qualified clinicians in the supervision of feeding tube placements. Only clinicians trained according to Avanos training should use the CORTRAK* 2.9 References: 1. Powers J, Brown B, Lyman B, et al. Development of a competency model for placement and verification of nasogastric and nasoenteric feeding tubes for adult hospitalized patients. Nutr Clin Pract. 2021;36(3):517-33. 2. Blumenstein I, Shastri YM, Stein J. Gastroenteric tube feeding: techniques, problems and solutions. World journal of gastroenterology: WJG. 2014;20(26):8505. 3. Koopmann MC, Kudsk KA, Szotkowski MJ, et al. A team-based protocol and electromagnetic technology eliminate feeding tube placement complications. Annals of surgery. 2011;253(2):297-302. 4. Smithard D, Barrett NA, Hargroves D, et al. Electromagnetic sensor-guided enteral access systems: a literature review. Dysphagia. 2015;30(3):275-85. 5. McCutcheon KP, Whittet WL, Kirsten JL, et al. Feeding tube insertion and placement confirmation using electromagnetic guidance: a team review. Journal of Parenteral and Enteral Nutrition. 2018;42(1):247-54. 6. Gray R, Tynan C, Reed L, et al. Bedside electromagnetic-guided feeding tube placement: an improvement over traditional placement technique? Nutr Clin Pract. 2007; 22(4):436-44. 7. Avanos CORTRAK 2 EAS brochure. 8. Pash E. Enteral nutrition: options for short‐term access. Nutr Clin Pract. 2018; 33(2):170-6. 9. CORTRAK 2 Quick Start Guide_15M1360.

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