AIRWAY MANAGEMENT MEDICAL DEVICES FOR LARYNGECTOMY AND TRACHEOTOMY CARE

Transcription

1 AIRWAY MANAGEMENT MEDICAL DEVICES FOR LARYNGECTOMY AND TRACHEOTOMY CARE

2 Edition/date: 04/2015 The manufacturer reserves the right to alterations to the products listed, especially technical alterations. Copyright The contents of this catalogue, including all of its parts and images are protected by copyright. Any use beyond the narrow limits of the copyright without the consent of the author is prohibited and subject to prosecution. This applies, in particular, to reproductions, translations, microfilming and the storage and processing of the data in electronic systems. This brochure contains only a small selection of our product range. More about our range of products you will find in our full-line catalog Airway Management and ADDRESS Andreas Fahl Medizintechnik-Vertrieb GmbH August-Horch-Straße 4a D Cologne (Porz-Gremberghoven) Phone: +49 (0) / Fax: +49 (0) / info@fahl.de Internet:

3 CONTENTS TRACHEOSTOMY TUBES 4 TRACHEOSTOMY TUBES - LINGO / PHON 11 TRACHEOSTOMY TUBES - CUFF 16 TRACHEOSTOMY TUBES - LINGO CUFF / PHON 20 TRACHEOSTOMY TUBES - SUCTION 24 VOICE PROSTHESES 27 SPEAKING VALVES 30 TRACHEOSTOMA VALVES 32 HME FILTER CASSETTES / BASE PLATES 33 TRACHEAL COMPRESSES 41 CLEANING AND CARE OF TUBES 44 CANNULA TUBE HOLDERS 47 TRACHEOSTOMA PROTECTION 50 INHALATION AND AIR HUMIDIFICATION 54 TRACHEAL SUCTION DEVICES 56 SPEECH AIDS/VOICE AMPLIFIERS 58 EMERGENCY AIDS 59 SIZING TRACHEOSTOMY TUBES 60 3

4 TRACHEOSTOMY TUBES We provide a wide range of tracheostomy tubes made from various materials and with different design patterns. This diversity is due to the fact that tracheostomy tubes should be ideally matched to the individual requirements of each patient. The doctor, who individually selects and adjusts the tubes for each patient, should be made aware of the complete range to allow him to select the best product for his patients. SILVERVENT 1 IC B v SILVERVENT 2 IC C v SILVERVENT 1 IC + 1 ICU C v U DURAVENT A l X DURAVENT XL A l DURAVENT 1 IC B v l 4

5 TRACHEOSTOMY TUBES X DURAVENT XL 1 IC B v l DURAVENT 2 IC C v l DURAVENT UNI 1 ICU B U l DURAVENT UNI 1 IC + 1 ICU C v U l X DURAVENT UNI XL 1 IC + 1 ICU C v U l DURAVENT UNI 2 ICU C U l DURAVENT KOMBI 1IC + 1 ICK C v K l 5

6 TRACHEOSTOMY TUBES K U DURAVENT SOLO-ADAPTER KOMBI DURAVENT SOLO-ADAPTER UNI LARYNGOTEC A l a LARYNGOTEC KOMBI A p l a LARYNGOTEC KOMBI CLIP A p l a DURATWIX JUNIOR PED UNI A z l i a DURATWIX JUNIOR PED L UNI A z l i a 6

7 TRACHEOSTOMY TUBES SPIRAFLEX UNI A z a TRACHEOTEC VARIO A. l a FAHL BIESALSKI 2 IC + Speaking alve C F v l a F l a F l a F l a FAHL BIESALSKI Speaking valve S FAHL BIESALSKI Speaking valve M FAHL BIESALSKI Speaking valve L DURATWIX UNI A z l a S DURATWIX UNI short A z l a 7

8 TRACHEOSTOMY TUBES DURATWIX UNI-VARIO 1 ICU + 1 ICV C U V l a S DURATWIX UNI-VARIO short 1 ICU + 1 ICV C U V l a DURATWIX IC v a v a S DURATWIX IC short DURATWIX ICU U a U a S DURATWIX ICU short DURATWIX ICV V a S DURATWIX ICV short V a DURATWIX ICU contrast U a 8

9 TRACHEOSTOMY TUBES DURATWIX ICK K a S DURATWIX ICK short K a DURATWIX SOLO-ADAPTER KOMBI K a DURATWIX SOLO-ADAPTER VARIO V a DURATWIX SOLO-ADAPTER UNI U a u u u u p u S S LARYNGOTEC Stoma Button FIX LARYNGOTEC Stoma Button FIX short LARYNGOTEC Stoma Button LARYNGOTEC Stoma Button short LARYNGOTEC KOMBI Stoma Button FIX

10 TRACHEOSTOMY TUBES p u p u p u S S LARYNGOTEC KOMBI Stoma Button FIX short LARYNGOTEC KOMBI Stoma Button LARYNGOTEC KOMBI Stoma Button short FAHL T-Tube FAHL Tracheo-Safe C a FAHL Tracheo-Safe P a 10

11 TRACHEOSTOMY TUBES - LINGO / PHON These tracheostomy tubes have an opening in the upper (convex) wall of the tube shaft facing the larynx, the so-called sieve-fenestration. While most conventional tracheostomy tubes have one or two simple holes the Fahl tracheostomy tubes have an elaborate sieve consisting of many small holes to reduce micro-aspiration and the ingrowth of granulation tissue. If an inner cannula is present, it has an oval opening corresponding to the sieve in the outer cannula. Sieve-fenestrated cannulas are used by tracheostomized patients with intact larynx who are able to speak, or by laryngectomized patients with voice prosthesis who still need a tracheostomy tube to stabilize the trachea and keep the tracheostoma open. In that case the sieve supports the speaking facility provided by the voice prosthesis. Sieve-fenestrated tracheostomy tubes are usually used in combination with a speaking valve. LARYNGOTEC LINGO A E l a LARYNGOTEC KOMBI LINGO A p E l a A E p l a LARYNGOTEC KOMBI CLIP LINGO LARYNGOTEC KOMBI CUT A p y l a PHONTRACH KOMBI LINGO-PHON A p E F l 11

12 TRACHEOSTOMY TUBES - LINGO / PHON DURATWIX UNI-VARIO LINGO 1 ICV + 1 ICFU C E U V c l a S DURATWIX UNI-VARIO LINGO short 1 ICV + 1 ICFU C E U V c l a DURATWIX UNI LINGO A. E l a S DURATWIX UNI LINGO short A. E l a DURATWIX PHON ICF F c a S DURATWIX PHON ICF short F c a DURATWIX ICF v c a 12

13 TRACHEOSTOMY TUBES - LINGO / PHON S DURATWIX ICF short v c a DURATWIX ICFU U c a S DURATWIX ICFU short U c a DURATWIX ICFV V c a S DURATWIX ICFV short V c a DURATWIX ICFK K c a S DURATWIX ICFK short K c a DURATWIX SOLO-ADAPTER KOMBI K a DURATWIX SOLO-ADAPTER VARIO V a 13

14 TRACHEOSTOMY TUBES - LINGO / PHON DURATWIX SOLO-ADAPTER UNI U a DURATWIX PLUG v a SILVERVENT LINGO-PHON 1 ICF B E F v c SILVERVENT MULTI 1 ICU + 1 ICF-O C E F U O c C E U K c l DURAVENT UNI-KOMBI LINGO 1 ICFU + 1 ICFK DURAVENT LINGO-PHON 1 IC + 1 ICF , C w E F v c DURAVENT UNI LINGO-PHON 1 ICU + 1 ICF 1 3, C w E F U c C w E F U c X DURAVENT UNI LINGO-PHON XL 1 ICU + 1 ICF

15 TRACHEOSTOMY TUBES - LINGO / PHON DURAVENT KOMBI LINGO-PHON 1 IC + 1 ICFK + 1 COMBIPHON C w E F v K c l C w E F U K c l C w E F U K c l C w E F U K O c l K U X DURAVENT UNI-KOMBI LINGO-PHON 1 ICU + 1 ICFK + 1 COMBIPHON DURAVENT UNI-KOMBI LINGO-PHON XL 1 ICU + 1 ICFK + 1 COMBIPHON DURAVENT MULTI 1 ICU + 1 ICFK + 1 COMBIPHON O 2 DURAVENT SOLO-ADAPTER KOMBI DURAVENT SOLO-ADAPTER UNI DURAVENT PLUG w 15

16 TRACHEOSTOMY TUBES - CUFF Cuffed tracheostomy tubes are used to seal the cannula against the tracheal wall. This is a requirement for artificial ventilation and/or to prevent accidental aspiration of secretions. The soft cuff with very thin walls is typically designed as a high volume/low pressure cuff (hv/lp) and fits snugly into the trachea to ensure a reliable seal. The inflation line is integrated into the wall of the (outer) cannula thus providing a rounded and smooth outer shape to avoid friction and irritations of the delicate mucosa, particularly around the tracheostoma. DURACUFF VARIO A. Y / a M DURACUFF VARIO M A. Y / a X DURACUFF VARIO XL A. Y / a DURACUFF UNI-VARIO 1 ICU + 1 ICV C Y U V / a M DURACUFF UNI-VARIO M 1 ICU + 1 ICV C Y U V / a X DURACUFF UNI-VARIO XL 1 ICU + 1 ICV C Y U V / a 16

17 TRACHEOSTOMY TUBES - CUFF M DURACUFF UNI M 1 ICU-O B Y U O / a DURACUFF CLIP SPIRAFLEX UNI CUFF A z Y / a TRACHEOTEC VARIO CUFF A. Y / a DURATWIX UNI CUFF A. Y / a S DURATWIX UNI CUFF short A. Y / a DURATWIX UNI-VARIO CUFF 1 ICU + 1 ICV C Y U V / a 17

18 TRACHEOSTOMY TUBES - CUFF S DURATWIX UNI-VARIO CUFF short 1 ICU + 1 ICV C Y U V / a DURATWIX IC v a v a S DURATWIX IC short DURATWIX ICU U a U a S DURATWIX ICU short DURATWIX ICV V a V a S DURATWIX ICV short DURATWIX ICK K a K a S DURATWIX ICK short DURATWIX ICU contrast U a 18

19 TRACHEOSTOMY TUBES - CUFF DURATWIX SOLO-ADAPTER KOMBI K a DURATWIX SOLO-ADAPTER VARIO V a DURATWIX SOLO-ADAPTER UNI U a DURATWIX PLUG v a MUCOPROTECT Cuff pressure gauge MUCOPROTECT Connection tube for cuff pressure gauge

20 TRACHEOSTOMY TUBES - LINGO CUFF / PHON These tracheostomy tubes combine the features of a cuffed tracheostomy tube with a sieve-fenestrated one: Cuffed tracheostomy tubes are used to seal the cannula against the tracheal wall. This is a requirement for artificial ventilation and/or to prevent accidental aspiration of secretions. The soft cuff with very thin walls is typically designed as a high volume/low pressure cuff (hv/lp) and fits snugly into the trachea to ensure a reliable seal. The inflation line is integrated into the wall of the (outer) cannula thus providing a rounded and smooth outer shape to avoid friction and irritations of the delicate mucosa, particularly around the tracheostoma. Sieve-fenestrated tracheostomy tubes have an opening in the upper (convex) wall of the tube shaft facing the larynx, the so-called sieve-fenestration. While most conventional tracheostomy tubes have one or two simple holes the Fahl tracheostomy tubes have an elaborate sieve consisting of many small holes to reduce micro-aspiration and the ingrowth of granulation tissue. If an inner cannula is present, it has an oval opening corresponding to the sieve in the outer cannula. Sieve-fenestrated cannulas are used by tracheostomized patients with intact larynx who are able to speak, or by laryngectomized patients with voice prosthesis who still need a tracheostomy tube to stabilize the trachea and keep the tracheostoma open. In that case the sieve supports the speaking facility provided by the voice prosthesis. Sieve-fenestrated tracheostomy tubes are usually used in combination with a speaking valve. DURATWIX UNI-VARIO LINGO-CUFF 1 ICV + 1 ICFU C E Y U V c / a S DURATWIX UNI-VARIO LINGO-CUFF short 1 ICV + 1 ICFU C E Y U V c / a DURATWIX PHON ICF F c a F c a S DURATWIX PHON ICF short

21 TRACHEOSTOMY TUBES - LINGO CUFF / PHON DURATWIX ICF v c a S DURATWIX ICF short v c a DURATWIX ICFU U c a S DURATWIX ICFU short U c a DURATWIX ICFV V c a S DURATWIX ICFV short V c a DURATWIX ICFK K c a K c a S DURATWIX ICFK short DURATWIX SOLO-ADAPTER KOMBI K a DURATWIX SOLO-ADAPTER VARIO V a 21

22 TRACHEOSTOMY TUBES - LINGO CUFF / PHON DURATWIX SOLO-ADAPTER UNI U a DURATWIX PLUG v a DURACUFF UNI-VARIO LINGO 1 ICV + 1 ICFU C w E Y U V c / a M DURACUFF UNI-VARIO LINGO M 1 ICV + 1 ICFU C w E Y U V c / a X DURACUFF UNI-VARIO LINGO XL 1 ICV + 1 ICFU C w E Y U V c / a DURACUFF VARIO-KOMBI LINGO 1 ICV + 1 ICFK C w E Y K V c / a 22

23 TRACHEOSTOMY TUBES - LINGO CUFF / PHON M DURACUFF VARIO-KOMBI LINGO M 1 ICV + 1 ICFK C w E Y K V c / a X DURACUFF VARIO-KOMBI LINGO XL 1 ICV + 1 ICFK C w E Y K V c / a DURACUFF CLIP MUCOPROTECT Cuff pressure gauge MUCOPROTECT Connection tube for cuff pressure gauge

24 TRACHEOSTOMY TUBES - SUCTION Tracheostomy tubes with suction line are cuffed tubes which offer the option of removing secretions which have accumulated above the inflated cuff. This is achieved by a fine tube which is integrated into the (outer) cannula to retain a rounded and smooth outer shape of the cannula to avoid friction and irritations of the delicate mucosa, particularly around the tracheostoma. The suction line can be connected to any suction unit. It has an orifice right above the cuff to ensure that all secretions can be removed. DURACUFF VARIO SUCTION A. Y W / a M DURACUFF VARIO SUCTION M A. Y W / a X DURACUFF VARIO SUCTION XL A. Y W / a TRACHEOTEC VARIO CUFF-SUCTION A. Y W / a DURACUFF UNI-VARIO SUCTION 1 ICU + 1 ICV C Y W U V / a 24

25 TRACHEOSTOMY TUBES - SUCTION M DURACUFF UNI-VARIO SUCTION M 1 ICU + 1 ICV C Y W U V / a X DURACUFF UNI-VARIO SUCTION XL 1 ICU + 1 ICV C Y W U V / a C w E Y W F V K c / a C w E Y W F V K c / a C w E Y W F V K c / a M X DURACUFF VARIO-KOMBI LINGO-PHON SUCTION 1 ICV + 1 ICFK + 1 COMBIPHON DURACUFF VARIO-KOMBI LINGO-PHON SUCTION M 1 ICV + 1 ICFK + 1 COMBIPHON DURACUFF VARIO-KOMBI LINGO-PHON SUCTION XL 1 ICV + 1 ICFK + 1 COMBIPHON

26 TRACHEOSTOMY TUBES - SUCTION DURACUFF CLIP MUCOPROTECT Cuff pressure gauge MUCOPROTECT Connection tube for cuff pressure gauge

27 VOICE PROSTHESIS The voice of a laryngectomized patient can be restored by placing a voice prosthesis during or after laryngectomy between the esophagus and the trachea. It restores two vital functions of the larynx: It facilitates a continuous air flow from the lungs via the lower trachea, through the voice prosthesis and the esophagus into the oral cavity. The exhaled air can be used for phonation. And it seals the trachea against the esophagus during eating and drinking. Thus no accidental aspiration of food can occur. There are basically two types of voice prostheses: Indwelling prostheses which need to be exchanged by the physician and non-indwelling prostheses which may be exchanged by the patient himself. A voice prosthesis needs to be replaced for various reasons. E.g. after a certain time the valve may not close properly anymore due to Candida growth or other sediments which may lead to aspiration or an enhanced air flow resistance. For details on this kind of surgical voice rehabilitation a specialized physician should be consulted. Blom-Singer Classic TM Indwelling Fr Blom-Singer Classic TM Indwelling Fr Blom-Singer Classic TM Indwelling - sterile Fr a Blom-Singer Classic TM Indwelling - sterile Fr a Blom-Singer Advantage Soft Valve Fr Blom-Singer Advantage Soft Valve Fr

28 VOICE PROSTHESIS Blom-Singer Advantage Hard Valve Fr Blom-Singer Dual Valve Fr Blom-Singer Rapid Response Special Length Fr Blom-Singer Rapid Response Special Length Fr Blom-Singer Rapid Response Large Flange Fr Blom-Singer Rapid Response Large Flange Fr Blom-Singer Duckbill patient-changeable Fr Blom-Singer Low-Pressure patient-changeable Fr Blom-Singer Low-Pressure patient-changeable Fr

29 VOICE PROSTHESIS Blom-Singer Plug Insert 1 16 Fr Blom-Singer Plug Insert 1 20 Fr Blom-Singer Indwelling Valved Insert 1 20 Fr Blom-Singer Dilator 1 18 Fr Blom-Singer Dilator 1 22 Fr LARYVOX DUO BRUSH incl. Clip LARYVOX Stoma Light

30 SPEAKING VALVES Speaking valves facilitate speaking for tracheotomized patients with a partly or fully intact larynx. They allow the patients to speak without finger occlusion of the tracheostoma. They open during inhalation and close during exhalation thereby guiding the exhaled air through the larynx, the vocal cords and the mouth cavity. Thus the patient is able to speak. They also provide enhanced hygiene since finger occlusion is no longer necessary. Speaking valves are available in various versions. They come with 15 connectors for attachment to tracheostomy tubes or with 22 adapters for attachment to stoma buttons and base plates or with the unique Fahl multiadapter which combines both connector/adapter types. Open position speaking valves are closed by the patient s own exhalation pressure, closed position speaking valves automatically close after inhalation thereby reducing the exhalation effort required by the patient and minimizing potential fatigue and exhaustion. Some speaking valves are combined with a heat-and-moisture exchange (HME) filter to pre-warm and pre-humidify the inhaled air along with filtering off dust particles of the inhaled air. COMBIPHON a COMBIPHON O O a COMBIPHON Low Resistance COMBIPHON O 2 Low Resistance O COMBIPHON SLIM

31 SPEAKING VALVES COMBIPHON SLIM O O HUMIDOPHONE HUMIDOPHONE PLUS HUMIDOPHONE PLUS O O 31

32 TRACHEOSTOMA VALVES These tracheostoma valves facilitate speaking for laryngectomized patients with a voice prosthesis. They allow the patients to speak without finger occlusion of the tracheostoma. They open during inhalation and close during exhalation thereby guiding the exhaled air through the voice prosthesis, the esophagus and the mouth cavity. Thus even a laryngecotmized patient is again able to speak. They also provide enhanced hygiene since finger occlusion is no longer necessary. Tracheostoma valves come with 22 adapters for attachment to stoma buttons and base plates. LARYVOX Hands-Free Valve Low Resistance LARYVOX Hands-Free Valve Kombi HME Low Resistance LARYVOX Hands-Free Valve Kombi HME Normal Resistance LARYVOX Hands-Free Valve TrachiNaze Normal Resistance LARYVOX Hands-Free Valve TrachiNaze Low Resistance LARYVOX Hands-Free Set 1x LARYVOX Hands-Free Valve Kombi HME Low Resistance 6x LARYVOX DUO BRUSH x 5x LARYVOX HME LARYVOX Tape COMFORT 5x OPTIGARD 5x OPTICLEAR

33 HME FILTER CASSETTES / BASE PLATES The HME (Heat-Moisture-Exchanger) filter cassettes, condition the air, protect the lower airways, improve the quality of speech and are simple to use,. A tracheostomy results in a loss of mouth/nose breathing, this means that the filtering, warming and humidification of the air has to happen in a different way. To prevent irritation of the airways, due to dry air, dust or harmful substances contained in the air, a filter is required. After surgery, tracheostomised/laryngectomised patients frequently suffer from increased production of mucous and coughing. These symptoms can impair speech rehabilitation and breathing. The regular use of HME filter cassettes with Heat and Moisture Exchangers alleviates the symptoms and increases the quality of life. Comfortable stoma closure The housing of the HME filter cassettes facilitates speaking for laryngectomised patients with a voice prosthesis. The stoma is closed for speaking with the simple touch of a finger, even through clothing. As soon as the finger is removed, the air can pass though the HME to facilitate unimpaired inhalation and exhalation. Inconspicuous Thanks to their low profile the HME filter cassettes are very inconspicuous. They are either connected to tracheostomy tubes or to stoma buttons or to special base plates. The user must take care to select the right connector/adapter. Most tracheostomy tubes have a 15 connector, stoma buttons and base plates have a 22 adapter. Fahl HMEs are available with either 15 connectors or 22 adapters or the unique combi-adapter which facilitates the connection to both types Base Plates are used by laryngectomized patients. They are self-adhesive carrier systems for HMEs or tracheostoma valves (speaking valves for laryngectomized patients). We offer many types of base plates with various shapes and sizes, made of different materials and with different adhesive strengths. They are selected according to the anatomy of the tracheostoma and the type of skin in order to achieve a long wearing period with an optimal attachment. An HME or tracheostoma valve may be fitted in the central opening with its 22 adapter. They can be changed separately from the base plate. LARYVOX HME LARYVOX HME HighFlow LARYVOX O 2 HME O 33

34 HME FILTER CASSETTES / BASE PLATES LARYVOX STYLE HME HighFlow SET x LARYVOX STYLE HME HighFlow 9x LARYVOX STYLE TOP lamella (3x gold / 3x silver / 3x blue metallic) 9x LARYVOX STYLE CAP round (3x gold / 3x silver / 3x blue metallic) LARYVOX STYLE HME SET x LARYVOX STYLE HME 9x LARYVOX STYLE TOP lamella (3x gold / 3x silver / 3x blue metallic) 9x LARYVOX STYLE CAP round (3x gold / 3x silver / 3x blue metallic) LARYVOX STYLE HME HighFlow Suitable for use with other LARYVOX STYLE products LARYVOX STYLE HME Suitable for use with other LARYVOX STYLE products. LARYVOX STYLE TOP lamella - Set x 3x 3x gold silver blue metallic 34

35 HME FILTER CASSETTES / BASE PLATES LARYVOX STYLE TOP lamella 3 blue metallic LARYVOX STYLE TOP lamella 3 gold LARYVOX STYLE TOP lamella 3 silver LARYVOX STYLE TOP lamella 3 beige LARYVOX STYLE CAP round - Set x 3x 3x gold silver blue metallic LARYVOX STYLE CAP round 3 blue metallic LARYVOX STYLE CAP round 3 gold LARYVOX STYLE CAP round 3 silver LARYVOX STYLE CAP round 3 beige

36 HME FILTER CASSETTES / BASE PLATES LARYVOX TOUCH HME HighFlow 30 blue metallic LARYVOX TOUCH HME HighFlow 30 gold LARYVOX TOUCH HME HighFlow 30 silver LARYVOX TOUCH HME HighFlow 30 beige LARYVOX TOUCH HME HighFlow 30 clear LARYVOX PRO HME HighFlow LARYVOX PRO HME

37 HME FILTER CASSETTES / BASE PLATES LARYVOX Tape STANDARD 15 round LARYVOX Tape STANDARD 15 oval LARYVOX Tape STANDARD 15 XL oval LARYVOX Tape FLEXIBLE 15 round LARYVOX Tape FLEXIBLE 15 oval LARYVOX Tape FLEXIBLE 15 XL oval LARYVOX Tape HYDROSOFT 15 round LARYVOX Tape HYDROSOFT 15 oval LARYVOX Tape HYDROSOFT 15 XL oval LARYVOX Tape COMFORT 15 round

38 HME FILTER CASSETTES / BASE PLATES LARYVOX Tape COMFORT 15 oval LARYVOX Tape COMFORT 15 XL oval LARYVOX Tape HYPOALLERGEN 15 round LARYVOX Tape HYPOALLERGEN 15 oval LARYVOX Tape HYPOALLERGEN 15 XL oval LARYVOX Tape EXTRA FINE 15 rectangular LARYVOX Seal LARYVOX Connect 1 22 > LARYVOX Adapt 3 15 > FAHL Decannulation-Set 15x LARYVOX Tape EXTRA FINE 1x LARYVOX Seal 1x COMBIPHON O

39 HME FILTER CASSETTES / BASE PLATES LARYVOX Starter Set x 3 LARYVOX Tape oval / rectangular 15x OPTICLEAR 15x OPTIGARD 15x 15x LARYVOX HME LARYVOX HME HighFlow 1x LARYVOX SECUTRACH Blom-Singer HME Blom-Singer TruSeal 30 standard Blom-Singer TruSeal contour 30 round Blom-Singer TruSeal contour 30 oval Blom-Singer TruSeal contour 30 standard HUMIDOTRACH HUMIDOTWIN i HUMIDOSTOM Junior

40 HME FILTER CASSETTES / BASE PLATES HUMIDOFIX a HUMIDUAL a HUMIDOSTOM O O 40

41 TRACHEAL COMPRESSES Tracheal Compresses (Dressings) are basically used for two reasons. They cushion the neck flange of a tracheostomy tube against the skin to avoid leasons, pain and pressure necroses. They further absorb tracheal secretions. Tracheal compresses are available in numerous types, differing in material, number of layers, size, shape and colour. Aluminium coated compresses and foam compresses reduce the adhesion of the compress to dried secretions or clotted blood and thus facilitate an atraumatic replacement. Compresses with a slit facilitate the replacement without the need to use a pair of scissors to cut them open or to remove the tracheostomy tube. For iediate post-operative use and open wounds a sterile compress should be used. SENSOTRACH ALU 10 8 x SENSOTRACH ALU SLIT 10 8 x SENSOTRACH ALU SLIT 10 8 x SENSOTRACH UNO 10 9 x 9, SENSOTRACH UNO SLIT 10 9 x 9, i i i SENSOTRACH UNO PED 10 6 x 7 SENSOTRACH UNO PED SLIT SENSOTRACH UNO PED ALU SLIT 10 6 x x 7 SENSOTRACH DUO 10 9 x 9,

42 TRACHEAL COMPRESSES SENSOTRACH DUO SLIT 10 9 x 9, i SENSOTRACH DUO PED 10 6 x i SENSOTRACH DUO PED SLIT 10 6 x SENSOTRACH DUO ALU 10 9 x 9, SENSOTRACH DUO ALU SLIT 10 9 x 9, SENSOTRACH DUO SKIN 10 9 x 9, SENSOTRACH DUO SKIN SLIT 10 9 x 9, SENSOTRACH 3-Plus 10 9 x 9, SENSOTRACH 3-Plus SLIT 10 9 x 9,

43 TRACHEAL COMPRESSES a a SENSOFOAM - sterile x 9 x 0,5 SENSOFOAM - sterile, small 10 6,5 x 6,5 x 0, a SENSOFOAM PAD - sterile 10 7,8 x 3, a SENSOFOAM PAD Professional - sterile 10 7,8 x 3, SENSOFOAM Professional - sterile 10 9 x 9, a 43

44 CLEANING AND CARE OF TUBES For reasons of hygiene and to avoid the risk of infection, the tracheostomy tubes should be thoroughly cleaned at least twice a day, more often during heavier secretion production. Our range of cleaning devices include products for gentle and hygienic cleaning and disinfection. Great care must be taken when handling tracheostomy tubes, especially when cleaning the tube with a cannula-cleaning brush. Should sharp edges or even cracks ever appear on a tracheostomy tube, on no account use it again, as this could lead to injuries of the mucous membranes in the trachea. Constant checking prevents potentilal injuries! OPTIBRUSH SET OPTIBRUSH CLEAN g OPTIBRUSH CONT OPTICIT ml OPTIFLUID Stoma oil 1 25 ml OPTIFLUID Stoma oil towel ml OPTIBRUSH OPTIBRUSH PLUS

45 CLEANING AND CARE OF TUBES OPTIBRUSH Basic OPTIBRUSH Swab 30 small OPTIBRUSH Swab XL 30 large OPTIFAHL Stoma cleaning wipes OPTIFAHL Stoma cleaning wipes box OPTICLEAR Adhesive remover OPTIGARD Protective dressing wipes LARYVOX Distance holder LARYVOX Tracheospreizer LARYVOX Tracheospreizer PED i 45

46 CLEANING AND CARE OF TUBES LARYVOX Tweezers FAHL Gauze Dressings 8-fold x FAHL Non-Woven Compress / 4-fold x

47 CANNULA TUBE HOLDERS We offer an extensive range of tracheostomy tube accessories for you. A tube holder is indispensable for securely fixing the tube in the tracheostoma. Tube holders are available in a large selection and should be matched to the tracheostomy tube. We provide tube holders for single and multiple use, in differing material qualities and fastening techniques. H - with plastic hook HM - with metal hook K - with adherent fastener KACLIP HM beige KACLIP H beige KACLIP H white KACLIP Clear H transparent i i i i i SUPRAFIX 11 H PED SUPRAFIX 11 K PED SUPRAFIX 13 H PED SUPRAFIX 13 K PED SUPRAFIX 15 H PED

48 CANNULA TUBE HOLDERS i SUPRAFIX 15 K PED SUPRAFIX 18 H SUPRAFIX 18 K SUPRAFIX 25 H SUPRAFIX 25 K SUPRAFIX 30 H SUPRAFIX 30 K SUPRAFIX 36 H SUPRAFIX 36 K OPTIFLAUSCH K OPTIFLAUSCH H i OPTIFLAUSCH K PED

49 CANNULA TUBE HOLDERS i OPTIFLAUSCH Slim K i OPTIFLAUSCH Slim K PED NECKFIX K NECKFIX Blue K NECKFIX Blue PED K i NECKFIX Duo K NECKFIX ENDO

50 TRACHEOSTOMA PROTECTION The tracheostoma reacts particularly sensitive to all outside influence. Since after a tracheostomy or a laryngectomy breathing occurs no longer through the mouth and the nose but through the tracheostoma some of the body s natural protective measures are lost. It is therefore important to attach specific care to the protection of the tracheostoma. This refers particularly to the humidification, warming and filtering of the inhaled air. The lack of these protective mechanisms may have an adverse effect on the health. For example, a chilled trachea often results in damaging the delicate mucous membranes. These, in turn, perform such important tasks as the transportation or fluids and the movement of foreign bodies out of the upper and lower airways were they normally can be coughed up. The dissication of the tracheal mucosa will cause irritations and increased secretion, partially with the formation of encrustations. Our products for trachestoma protection replace the necessary protective mechanisms. On the one hand they protect the tracheostoma and trachea from the cold and from drying out on the other hand they prevent the ingress of dirt particles and absorb leaking secretions. Without tracheostoma protection the inhaled air would enter through the tracheostoma too cold and too fast. Specific protection items provide a barrier, reducing the speed or the airflow, warming and humidifying the air. At the same time tracheostoma protection products provide visual protection and with it, a certain degree of security. Our tracheostoma protection products combine aesthetics with comfort. The neckerchiefs and scarves, for example, are offered in fashionable, attractive design patterns. Please refer to our colour sample card for colours and patterns: 3L: 3-layered 5L: 5-layered 8L: 8-layered 12L: 12-layered TRACHEOTEX BIB 3L TRACHEOTEX BIB 5L TRACHEOTEX BIB 8L TRACHEOTEX BIB 12L

51 TRACHEOSTOMA PROTECTION TRACHEOTEX BIB 3L PED i TRACHEOTEX BIB 5L PED i BUCHANAN BIB L 10 max x 19 BUCHANAN BIB S 10 max x 12 TRACHEOTEX Scarf TRACHEOTEX EASY 1 max TRACHEOTEX ROLLI 1 min TRACHEOTEX Shirt 1 min

52 TRACHEOSTOMA PROTECTION LARYNGOFIX S beige 10 4 x 5, LARYNGOFIX L beige 10 4,8 x 6, LARYNGOFIX S white 10 4 x 5, LARYNGOFIX L white 10 4,8 x 6, LARYNGOFIX PLUS S beige 10 4 x 5, LARYNGOFIX PLUS L beige 10 4,8 x 6, LARYNGOFIX PRO S 10 4,0 x 5, LARYNGOFIX PRO L 10 4,8 x 6, TRACHEOSTOMA-FIX S beige 10 6 x 6, TRACHEOSTOMA-FIX L beige 10 7 x 7, TRACHEOFIX S white 10 5,5 x

53 TRACHEOSTOMA PROTECTION TRACHEOFIX L white 10 7 x TRACHEOFIX S beige 10 5,5 x TRACHEOFIX L beige 10 7 x TRACHEOFIX PLUS S beige 10 5,5 x TRACHEOFIX PLUS L beige 10 7 x LARYTAPE S 10 4 x 5, LARYTAPE L 10 4,8 x 6, LARYTAPE TOUCH S 10 4 x 5, LARYTAPE TOUCH L 10 4,8 x 6, LARYVOX SECUTRACH Shower guard SECUTRACH Shower guard

54 INHALATION AND AIR HUMIDIFICATION After a laryngectomy or tracheostomy, the breathing will have changed. The patient now breathes through a tracheostoma. In mouth/nose breathing, the inshaled air is naturally kept moist. After the loss of this natural humidification effects of the mucous membranes a different method is required in order to prevent severe irritation by dissication of the mucous membranes. In most cases this type of severe irritation leads to increased secretion, coughing and encrustation. To avoid these consequences, it is essential to inhale regularly and ensure that the airways are continuously kept at a constant air humidity of approx %. NEBUFIRST NEBUPORT LARYVOX Nebulizer NEBUJUNIOR Bear NEBUJUNIOR Penguin

55 INHALATION AND AIR HUMIDIFICATION HUMIDOBAC / HME HUMIDOBAC HUMIDONEB FLEX Catheter mount HUMIDONEB FLEX Catheter mount S HUMIDONEB Nebulizer Set HUMIDONEB Oxytube

56 TRACHEAL SUCTION DEVICES Tracheal suction devices are important devices for the care after a laryngectomy or tracheostomy. After surgery, patients generally experience increased secretion. This means great stress for the respiratory system, leading to irritation and coughing. A tracheal suction device is an important tool, helping to remove secretions from the respiratory tract. The tracheal suction device is also a great help in other situations, for example, to alleviate respiratory diseases. In such cases, the tracheal suction device facilitates breathing by relieving the tracheostoma from excessive bronchial secretions. Before using a tracheal suction device, please note the instructions included in the respective device s instruction manual. Suction takes place through sterile stoma catheters, which we offer in various sizes and types. TRACHEOPORT COMPACT Battery 1 24 l TRACHEOFIRST COMPACT 1 24 l a Stoma catheter Metric L CH a Tracheostoma catheter Metric S CH a TRACHFLOW Metric S CH a TRACHFLOW Metric L CH

57 TRACHEAL SUCTION DEVICES RESPITRACH Permanent suction catheter a TRACHFLOW Finger-Tip a TRACHFLOW Stepconnector TRACHFLOW Line Pro 1 1,30 m TRACHFLOW Silicone suction tube S TRACHFLOW Line Connect

58 SPEECH AIDS/VOICE AMPLIFIERS After successful laryngectomy, it is most important for the patient to be able to speak as quickly as possible again and to be well understood. That is why we recoend speech therapy by a certified speech therapist. The speech therapist will usually start speech rehabilitation with the esophageal voice. Parallel to this, speaking with an electronic speech aid can also be a part of the voice rehabilitation. The electronic speech aid generates sound oscillations, these are transmitted to the mouth/pharynx area when the device is slightly pressed to the neck, and can thereby transform the normal speech motions into comprehensible speech. The VOICETEC voice amplifier enables excellent amplification of a quiet oesophageal voice and is also well suited for patients/users with vocal chord damage. It can be used whenever a louder conversation volume is desired, to, e.g., be understood even with high levels of background noise. With the help of the VOICETEC voice amplifier, it is possible, even without strenuous attempts, to speak loudly. The wireless, radio-controlled transmitter unit enables the greatest of mobility. This extends the patient s comfort and field of application. VOICETEC ElectroLarynx Speech Aid LARYVOX Alarm

59 EMERGENCY AIDS There are special aids for neck breathers, which can be particularly helpful in emergencies, in individual cases, perhaps even life saving. LARYVOX SOS safe-mask LARYVOX SOS mask LARYVOX Smell LARYVOX Safety Set 1x LARYVOX SOS safe-mask 1x LARYVOX Tweezers 1x LARYVOX Connect 5x LARYVOX O 2 Connect 5x LARYVOX O 2 HME 5x LARYVOX Tape COMFORT / XL oval 1x Oxygen connecting tube LARYVOX Emergency Set 1x LARYVOX SOS safe-mask 1x TRACHEOTEC VARIO CUFF, 7 1x LARYVOX Tracheospreizer 1x LARYVOX Connect 5x LARYVOX O 2 Connect 5x LARYVOX Tape COMFORT / XL oval 3x OPTIFLUID Stoma oil towel 1x Oxygen connecting tube

60 SIZING TRACHEOSTOMY TUBES Tracheostomy tubes are available in different materials and different versions. A good fit of the cannula is essentially determined by two factors, the cannula diameter and the cannula length. As the sizing of the individual cannula manufacturers is based on different measuring principles, these cannot always be directly LARYNGOTEC PHONTRACH DURAVENT LARYNGOTEC Button SILVERVENT Tip Tip Tip Shield Shield Tip Shield CIRCULAR TEMPLATES To determine the outer diameter at the cannula tip in. From 3 18 in 0.5 steps. 3 3,5 4 4,5 5 5,5 6 6,5 7 7,5 8 8,5 9 9, , , ,5 In the selection of tracheostomy tubes of different materials, it should be noted that the material strength could also influence the inner lumen of the cannula. For example, because of the thick-walled material, a non-metal cannula has a smaller inner volume than the thin-walled silver cannula. In comparison, the inner diameter at the cannula tip will therefore play a role. In some tracheostomy tubes, the lengths of the middle radius or the middle length are

61 ANDREAS FAHL MEDIZINTECHNIK-VERTRIEB GMBH compared. Exact measurement is often necessary, whereby certain aids can be helpful in measuring, e.g., a flexible measuring tape. The following overview shows how the cannula diameter and length can be determined. It also illustrates which measurements are most coonly used. DURACUFF DURATWIX DURATWIX JUNIOR PED SPIRAFLEX TRACHEOTEC FAHL BIESALSKI Tip Shield Tip Shield Tip Tip Tip Tip Shield , , , , ,5 18 also stated. These are the mean bending radius of the cannula tube, i.e., the radius of the (geometric) middle layer of the tube bend. The following table is intended to facilitate the determination of the outer diameter at the cannula tip. The diameter can simply be determined by placing the cannula (tip) on the template

62 SIZING TRACHEOSTOMY TUBES SILVERVENT DURAVENT standard / XL TRACHEOTEC Tip Shield I.D. Length Shield A.D. Schild I.D. Length Tip Shield I.D. Length / / / / / / / / / / / / SPIRAFLEX standard PHONTRACH DURATWIX JUNIOR PED Tip Shield I.D. Length Tip Shield I.D. Length Tip I.D. Length DURACUFF standard / medium / XL LARYNGOTEC Button standard / short DURATWIX standard / short Tip Shield I.D. Length Shield I.D. Length Tip Shield I.D. Length / 75 / / / / 80 / / / / 85 / / / / 95 / / / / 97 / / / / 100 / 120 FAHL BIESALSKI LARYNGOTEC Tip Shield I.D. Length Tip Shield I.D. Length / 62 / / 62 / / 62 / / 62 / / 62 / / 62 / / 62 / 90 62

63 BEFORE THE LARYNGECTOMY/TRACHEOSTOMY AFTER THE LARYNGECTOMY VOICE VOICE LARYNX VOCAL FOLDS VOICE-PRODUCING PE SEGMENT TRACHEOSTOMA OESOPHAGUS TRACHEA OESOPHAGUS AIRFLOW FROM AND TO LUNGS TRACHEA AFTER THE LARYNGECTOMY WITH SPEECH AID AFTER THE TRACHEOSTOMY VOICE VOICE ELECTRONIC SPEECH AID VOCAL FOLDS SPEAKING VALVE OESOPHAGUS AIRFLOW FROM AND TO LUNGS OESOPHAGUS AIRFLOW FROM AND TO LUNGS TRACHEA TRACHEOSTOMY TUBE WITH SIEVE AFTER THE LARYNGECTOMY WITH VOICE PROSTHESIS AFTER THE LARYNGECTOMY WITH HME VOICE VOICE OESOPHAGUS VOICE-PRODUCING PE SEGMENT VOICE PROSTHESIS (SHUNT VALVE) AIRFLOW FROM AND TO LUNGS OESOPHAGUS VOICE-PRODUCING PE SEGMENT VOICE PROSTHESIS (SHUNT VALVE) RETAINING PLATE (BASE PLATE WITH FILTER (HME) AIRFLOW FROM AND TO LUNGS TRACHEOSTOMY TUBE TRACHEA

64 PICTOGRAM LEGEND Pictogram Description Outer cannula A Outer cannula with no inner cannula B Outer cannula with one inner cannula C Outer cannula with two inner cannulas D Outer cannula with three inner cannulas z Outer cannula including 15 -connector (UNI) p Outer cannula including 22 -connector (KOMBI). Outer cannula including 15 -swivel connector (VARIO) u Stoma button w Decannulation plug E x y Y W F Inner cannula v U V K c O Several small fenestration holes in a specific arrangement in the center of the tube, is referred to as sieve (LINGO) Outer cannula fenestrated Outer cannula with a slit With low-pressure cuff (CUFF) With suction device ( SUCTION) Speaking valve (PHON) Inner cannula with low profile Inner cannula with 15 -connector (UNI) Inner cannula with 15 -swivel connector (VARIO) Inner cannula with 22 -connector (KOMBI) Inner cannula fenestrated With oxygen support General S Length short M Length medium X Length XL l MRT suitable i Specially for children / For artificial ventilation a Sterile LIST OF ABBREVIATIONS Abbreviation Description LINGO Sieve-fenestrated CUT With a slit CUFF With low-pressure cuff SUCTION With suction device MULTI Multi function XL Length XL M Length medium Short Length short PHON With speaking valve UNI With 15 -connector VARIO With 15 -swivel connector KOMBI With 22 -connector FIX Button with fastening eyelets Abbreviation Description IC ICF ICU ICFU ICV ICFV ICK ICFK O2 Inner cannula Inner cannula, fenestrated IC with 15 -connector (UNI) IC with 15-connector (UNI), fenestrated IC with 15 -swivel connector (VARIO) IC with 15 -swivel connector (VARIO), fenestrated IC with 22 -connector (KOMBI) IC with 22 -connector (KOMBI), fenestrated IC with oxygen support

65 Andreas Fahl Medizintechnik-Vertrieb GmbH August-Horch-Str. 4a Köln - Germany Phone +49 (0) / Fax +49 (0) / info@fahl.de Your local distributor: Fb 1685/02 Product Selection Airway Management short EN 04/2015