AIRWAY MANAGEMENT SOLUTIONS

KAPITEX HEALTHCARE - SPECIALIST KNOWLEDGE, SUPPORT AND CARE AIRWAY MANAGEMENT SOLUTIONS Specialist tracheostomy management solutions you can trust

Kapitex - Adding Quality of Life to Airway Management Tracheostomy management solutions from the specialists Kapitex Healthcare Kapitex offers a very wide range of tracheostomy tubes from the initial percutaneous systems to long term tubes and those designed to meet special clinical requirements. Kapitex have a comprehensive choice of tracheostomy management essentials in addition to the tracheostomy tube. This includes holders, dressings, cleaning swabs and skin protection products. Kapitex look forward to providing an on-going supply and support which you can put your trust in. Kapitex Customer Services Tel: 01937 580211 Fax: 01937 580796 Email: sales@kapitex.com www.kapitex.com

Tracoe experc percutaneous dilation tracheostomy set 4 Certified Quality Products Our products meet the requirements of the most demanding applications and comply with all relevant national and international guidelines and standards. They are registered and approved in many countries world-wide. Product descriptions Please note that due to continuous product developments it may be necessary to alter, without notice, products within our range. We endeavour to keep all customers informed of product improvements. Purchased products may differ in appearance from the illustrations shown in this brochure. Kapitex Healthcare 2013 Tracoe twist tracheostomy tubes Tracoe twist Plus tracheostomy tubes Tracoe vario flexible tracheostomy tubes Tracoe comfort long-term tracheostomy tubes Tracoe mini paediatric tracheostomy tubes 14 24 32 40 52 Passy-Muir tracheostomy speaking valves 56 Moore tubes extra long tracheostomy tubes 59 Silver tubes sterling silver tracheostomy tubes 60 Kapitex stoma studs 62 Kapitex laryngectomy tubes 63 Trachi-Hold tracheostomy tube holders 64 Trachi-Dress sterile tracheostomy dressings 65 Trachi-Dress F sterile foam tracheostomy dressings 66 Tracheostomy Management Aids 68

Tracoe experc Percutaneous System Key features Dilation is carried out according to the well-tried Ciaglia technique The atraumatic inserter ensures a stepless transition between the inserter and tracheostomy tube minimising the risk of injuring the trachea during tube insertion The safety stop at the neck flange on the atraumatic inserter avoids insertion of the tube too deeply, thereby minimising the risk of injury The separately available Tracoe twist, Tracoe twist Plus and Tracoe vario tracheostomy tubes with atraumatic inserter can also be used for reinsertion or the changing of tubes after percutaneous tracheostomy 4 Featuring the unique NO STEP insertion device ensuring a smooth tracheostomy

Percutaneous dilation tracheostomy sets with atraumatic inserter Tracoe experc Percutaneous tracheostomy system A proven technique Percutaneous dilation tracheostomy has established itself as a standard procedure in intensive care medicine. The Ciaglia technique is the one most widely used. The Tracoe experc system is based on this proven method. There is no need to learn a new procedure. The sets are tailored for the use of unfenestrated and fenestrated tubes including tubes with subglottic suction line (Tracoe twist, Tracoe twist Plus and Tracoe vario, not fenestrated). Tracoe experc Percutaneous System The Innovation Inserting the Tracheostomy tube can be a challenge. The Tracoe experc sets deliver the solution in the form of the unique, patented atraumatic inserter. A silicone sleeve at the tip of the insertion instrument smoothly bridges the gap between the inserter and the tube. This allows the tube to be inserted easily and safely. Option for Reinsertion For difficult reinsertion situations unfenestrated and fenestrated Tracoe twist, twist Plus and unfenestrated Tracoe vario tubes are available. They are available individually premounted with the atraumatic inserter. The Seldinger guide wire should be used in any difficult situation. The Experc Percutaneous Kit is available with: Tracoe twist tracheostomy tubes with atraumatic inserter Tracoe twist Plus tracheostomy tubes with atraumatic inserter Tracoe vario tracheostomy tubes with atraumatic inserter The tracheostomy tubes with atraumatic inserter are also available separately. 5

Tracoe experc set with Tracoe twist Tracoe experc set with Tracoe twist tracheostomy tube Key features The special feature of the Tracoe experc percutaneous dilation tracheostomy set is the atraumatic inserter of the tracheostomy tube. Its tip has a folding silicone sleeve that smoothly bridges over the inserter and end of the tube (fig1 ). The inserter has a precise fit into the tube and a stop at the 15mm connector. Once the tube is in the trachea the inserter is pulled out of the tube. In doing so the silicone sleeve rolls back to allow easy removal (fig 2). The atraumatic inserter ensures a stepless transition between the inserter and tracheostomy tube minimising the risk of injuring the trachea during tube insertion. The atraumatic inserter is pre-loaded and should not be removed from the tube prior to use. The separately available Tracoe twist, with atraumatic inserter can also be used for reinsertion or the changing of tubes after percutaneous tracheostomy. Fig.1 A collapsible sleeve at the tip of the introducer enables a unique stepless transition between the inserter tip and the patient end of the tube. Fig.2 After the tube with atraumatic inserter is inserted into the trachea the inserter is pulled out. On removal the silicone sleeve is pulled back and the inserter can be removed easily. 520 Tracoe experc percutaneous dilation set (WITHOUT TUBE) Scalpel Syringe Puncture needle (14 G) with Teflon catheter Seldinger guide wire made of kink resistant Nitinol with inserter Short dilator 14 CH/FR Guiding catheter with safety stop Tracoe experc dilator with hydrophilic coating (allows easy insertion after moistening) 4 gauze swabs 10 x 10cm Order Code: Experc set only TR EXS 5201 x1 set (WITHOUT TUBE) The Seldinger guide wire only and Seldinger guide wire with white guiding catheter are available as separate components (see page 13). 6 Tracoe experc

Tracoe experc set with Tracoe twist P tracheostomy tube Available with 3 styles of tube, unfenestrated, fenestrated and with subglottic suction line, 320, 321 and 322. The Tracoe twist tubes with atraumatic inserter (Ref 301-P / Ref 302-P / Ref 306-P ) are also available separately (see pages 19-20). 320 Tracoe experc twist set with 301-P tube x1 Tracoe experc Dilation Set (Ref 520) x1 Tracoe twist tracheostomy tube with low pressure cuff and atraumatic inserter (Ref 301-P) x2 inner tubes 321 Tracoe experc twist set with 302-P tube x1 Tracoe experc Dilation Set (Ref 520) x1 Tracoe twist tracheostomy tube, fenestrated with low pressure cuff and atraumatic inserter (Ref 302-P) x1 fenestrated and x1 unfenestrated inner tubes Tracoe experc set with Tracoe twist P 322 Tracoe experc twist set with 306-P tube x1 Tracoe experc Dilation Set (Ref 520) x1 Tracoe twist tracheostomy tube with low pressure cuff, subglottic line and atraumatic inserter (Ref 306-P) x2 inner tubes Ordering information - Tracoe experc Set twist Product Size Order number Tracoe experc 320 Percutaneous Dilation Tracheostomy Set (Ref 520) with Tracoe twist tube unfenestrated with low pressure cuff and atraumatic inserter (Ref 301-P) Tracoe experc 321 Percutaneous Dilation Tracheostomy Set (Ref 520) with Tracoe twist tube fenestrated with low pressure cuff and atraumatic inserter (Ref 302-P) Tracoe experc 322 Percutaneous Dilation Tracheostomy Set (Ref 520) with Tracoe twist tube unfenestrated with subglottic suction line, low pressure cuff and atraumatic inserter (Ref 306-P) 7 TR EXS 2007 8 TR EXS 2008 9 TR EXS 2009 7 TR EXS 2107 8 TR EXS 2108 9 TR EXS 2109 7 TR EXS 2207 8 TR EXS 2208 9 TR EXS 2209 For further details, please contact Kapitex Customer Services on 01937 580211 7

Tracoe experc with Tracoe twist Plus P Tracoe experc set with Tracoe twist Plus P tracheostomy tube Key features The special feature of the Tracoe experc percutaneous dilation tracheostomy set is the atraumatic inserter of the tracheostomy tube. The system consists of two parts: the white guiding catheter with silicone sleeve and the green inserter fitted into the inner cannula of the tracheostomy tube. The silicone sleeve smoothly bridges over the gap in diameter between the end of the tube and the inserter thus minimising the risk of injury when inserting the tracheostomy tube into the trachea (see fig 1). The Tracoe twist Plus P tracheostomy tubes are delivered pre-mounted, including the guide catheter with the atraumatic insertion system, into the inner cannula with the 15mm connector. The insertion system stabilises and assists guiding the tube; it provides a precise fit into the tube and a stop at the 15mm connector. Once the tube is in the trachea the green inserter and the white guiding catheter with silicone sleeve are grabbed as a unit and removed together. By doing so, the silicone sleeve flaps back and the guiding catheter can be removed easily (see fig.2). The Seldinger guide wire can be removed either prior or together with the white guiding catheter. Alternatively the green inserter can be removed first, followed by the white guiding catheter and the Seldinger guide wire. Note: under no circumstances should the white guiding catheter be removed first. Fig.1 A collapsible sleeve at the introducer tip enables a unique stepless transition between the inserter tip and the distal end of the tube. Fig.2 After the tube with atraumatic inserter is inserted into the trachea the inserter is pulled out. Thereby the silicone sleeve turns down and the inserter can be removed easily. 520 Tracoe experc percutaneous dilation set (WITHOUT TUBE) Scalpel Syringe Puncture needle (14 G) with Teflon catheter Seldinger guide wire made of kink resistant Nitinol with inserter Short dilator 14 CH/FR Guiding catheter with safety stop Tracoe experc dilator with hydrophilic coating (allows easy insertion after moistening) 4 gauze swabs 10 x 10cm Order Code: Experc set only TR EXS 5201 x1 set (WITHOUT TUBE) The Seldinger guide wire only and Seldinger guide wire with white guiding catheter are available as separate components (see page 13). 8 Tracoe experc

Tracoe experc set with Tracoe twist Plus P tracheostomy tube The Tracoe experc percutaneous dilation tracheostomy set is supplied with a Tracoe twist Plus P tracheostomy tube, either unfenestrated (Ref 330) or double fenestrated (Ref 331) or with subglottic suction line (Ref 322) in sizes 07, 08 or 09. The tracheostomy tube for the Tracoe experc set includes an atraumatic inserter ensuring a stepless transition between inserter and end of the tube. 330 Tracoe experc set twist Plus with 311-P tube x1 Tracoe experc Dilation Set (Ref 520) x1 Tracoe twist Plus tracheostomy tube unfenestrated with low pressure cuff and atraumatic inserter (Ref 311-P) x2 inner tubes 331 Tracoe experc set twist Plus with 312-P tube x1 Tracoe experc Dilation Set (Ref 520) x1 Tracoe twist Plus tracheostomy tube, double fenestrated with low pressure cuff and atraumatic inserter (Ref 312-P) x1 fenestrated and x1 unfenestrated inner tubes Tracoe experc with Tracoe twist Plus P Ordering information - Tracoe experc Set twist Plus 332 Tracoe experc set twist Plus with 316-P tube x1 Tracoe experc Dilation Set (Ref 520) x1 Tracoe twist Plus tracheostomy tube unfenestrated with low pressure cuff, subglottic line and atraumatic insertion system (Ref 316-P) x2 inner tubes Product Size Order number Tracoe experc 330 Percutaneous Dilation Tracheostomy Set (Ref 520) with Tracoe twist Plus P tube unfenestrated with low pressure cuff and atraumatic inserter (Ref 311-P) Tracoe experc 331 Percutaneous Dilation Tracheostomy Set (Ref 520) with Tracoe twist Plus P tube double fenestrated with low pressure cuff and atraumatic inserter (Ref 312-P) Tracoe experc 332 Percutaneous Dilation Tracheostomy Set (Ref 520) with Tracoe twist Plus P tube unfenestrated with subglottic suction line, low pressure cuff and atraumatic insertion system (Ref 316-P) 7 TR EXS 3307 8 TR EXS 3308 9 TR EXS 3309 10 TR EXS 3310 7 TR EXS 3317 8 TR EXS 3318 9 TR EXS 3319 10 TR EXS 3320 7 TR EXS 3327 8 TR EXS 3328 9 TR EXS 3329 10 TR EXS 3330 Tracoe twist tubes 311-P, 312-P and 316-P are also available separately (see pages 27-28) 9

Tracoe experc with Tracoe vario Tracoe experc set with Tracoe vario tracheostomy tube Key features Fig.1 The unique design of the silicone sleeve on the Experc Percutaneous vario introducer provides the smoothest of insertions, thereby making introduction of the tube easier and minimising risk of trauma. Fig.2 Simple operation Once the vario tube is in the trachea, remove the inserter with the guiding catheter with the silicone sleeve. Upon removal the silicone sleeve rolls back, making the guiding catheter removal easy. The special feature of the Tracoe experc vario tracheostomy tube set is the preloaded atraumatic inserter. The Benefits Dilation is performed using the proven Ciaglia onestep-technique. The atraumatic insertion system insures a stepless transition between the inserter and the tracheostomy tube. The stop at the 15mm connector prevents the inserter being inserted too far into the tube, which additionally reduces the risk of injury. The separately available tubes with the insertion system can be used for reinsertion and tube changes. The Seldinger guide wire can be removed prior or together with the guiding catheter. Note: Under no circumstances must the guiding catheter be removed first inserter Tracoe vario tubes Ref 450-P, 451-P, 470-P and 471-P as well as the experc Dilation Set (Ref 520) are also available separately. See page 34. guiding catheter 520 Tracoe experc percutaneous dilation set (WITHOUT TUBE) Scalpel Syringe Puncture needle (14 G) with Teflon catheter Seldinger guide wire made of kink resistant Nitinol with inserter Short dilator 14 CH/FR Guiding catheter with safety stop Tracoe experc dilator with hydrophilic coating (allows easy insertion after moistening) 4 gauze swabs 10 x 10cm Order Code: Experc set only TR EXS 5201 x1 set (WITHOUT TUBE) The Seldinger guide wire only and Seldinger guide wire with white guiding catheter are available as separate components (see page 13). 10 Tracoe experc

Tracoe experc set with Tracoe vario tracheostomy tube The Tracoe experc percutaneous dilation tracheostomy set (Ref 520) is supplied with one of the following Tracoe vario tracheostomy tubes: Ref 450-P / 451-P/ 470-P / 471-P. The tracheostomy tube for the Tracoe experc set includes an atraumatic inserter ensuring a stepless transition between inserter and end of the tube. Tracoe vario tubes with atraumatic inserter are also available separately. 420 Tracoe experc set vario with vario 450-P tube x1 Tracoe experc Dilation Set (Ref 520) x1 Tracoe vario tracheostomy tube wire reinforced with adjustable neck flange, low pressure cuff and atraumatic insertion system (Ref 450-P) Tracoe experc with Tracoe vario 421 Tracoe experc set vario with vario 451-P tube x1 Tracoe experc Dilation Set (Ref 520) x1 Tracoe vario XL tracheostomy tube wire reinforced with adjustable neck flange, low pressure cuff and atraumatic insertion system (Ref 451-P) 422 Tracoe experc set vario with vario 470-P tube x1 Tracoe experc Dilation Set (Ref 520) x1 Tracoe vario tracheostomy tube not wire reinforced with adjustable neck flange, low pressure cuff, subglottic suction line and atraumatic insertion system (Ref 470-P) Ordering information - Tracoe experc Set vario Product Size Order number Tracoe experc 420 Percutaneous Dilation Tracheostomy Set (Ref 520) with Tracoe vario tracheostomy tube with adjustable neck flange, wire reinforced, with low pressure cuff and atraumatic insertion system (Ref 450-P) Tracoe experc 421 Percutaneous Dilation Tracheostomy Set (Ref 520) with Tracoe vario XL tracheostomy tube with adjustable neck flange, wire reinforced, with low pressure cuff and atraumatic insertion system (Ref 451-P) Tracoe experc 422 Percutaneous Dilation Tracheostomy Set (Ref 520) with Tracoe vario tracheostomy tube with adjustable neck flange, not wire reinforced, with low pressure cuff, subglottic suction line and atraumatic insertion system (Ref 470-P) 7 TR EXS 4207 8 TR EXS 4208 9 TR EXS 4209 7 TR EXS 4217 8 TR EXS 4218 9 TR EXS 4219 8 TR EXS 4228 9 TR EXS 4229 11

Tracoe experc Percutaneous set Reference Guide Tracoe experc percutaneous set reference guide The Tracoe experc percutaneous dilation tracheostomy set (Ref 520) can be supplemented with the tracheostomy tube which is best suited for the patient: Tracoe twist Tracoe twist 301-P (page 19) as Tracoe experc set 320 (page 7) Tracoe twist 302-P (page 19) as Tracoe experc set 321 (page 7) Tracoe twist Plus Tracoe twist Plus 311-P (page 27) as Tracoe experc set 330 (page 9) Tracoe twist Plus312-P (page 27) as Tracoe experc set 331 (page 9 Tracoe twist Tracoe vario tracheostomy tubes for patients requiring adjustable neck flanges Tracoe vario 450-P (page 36) as Tracoe experc set 420 (page 11) Tracoe vario 451-P (page 36) as Tracoe experc set 421 (page 11) For patients requiring subglottic suction Tracoe twist 306-P (page 20) as Tracoe experc set 322 (page 7) Tracoe twist Plus 316-P (page 28) as Tracoe experc set 332 (page 9) Tracoe vario 470-P (page 36) as Tracoe experc set 422 (page 11) Ref 301-P Tracoe twist, not fenestrated Ref 302-P Tracoe twist, fenestrated Ref 306-P Tracoe twist, not fenestrated with subglottic suction line Tracoe twist Plus Ref 312-P Tracoe twist Plus, double fenestrated Ref 316-P Tracoe twist Plus, not fenestrated with subglottic suction line Ref 311-P Tracoe twist Plus, not fenestrated Tracoe vario Ref 450-P Tracoe vario, spiralreinforced Ref 460-P Tracoe vario, not spiralreinforced Ref 451-P Tracoe vario, extra long spiral-reinforced Ref 470-P Tracoe vario, not spiralreinforced with subglottic suction line All Tracoe tracheostomy tubes for the percutaneous tracheostomy are available in sizes 07, 08 and 09 except Tracoe vario 470-P and 471-P which are only available in sizes 08 and 09.Tracoe twist Plus tracheostomy tubes are also available in size 10 12 Tracoe experc

Tracoe experc Accessories Tracoe experc Accessories 517 Seldinger guide wire with guiding catheter Seldinger guide wire made of kink resistant Nitinol Guiding catheter To be used with all Tracoe twist tubes with atraumatic inserter 518 Seldinger guide wire Seldinger guide wire made of kink resistant Nitinol Pack of 5 Order Code: TR EXW 0001 x1 set Order Code: TR EXW 0002 x5 pieces 520 Tracoe experc percutaneous dilation set (WITHOUT TUBE) Scalpel Syringe Puncture needle (14 G) with Teflon catheter Seldinger guide wire made of kink resistant Nitinol with inserter Short dilator 14 CH/FR Guiding catheter with safety stop Tracoe experc dilator with hydrophilic coating (allows easy insertion after moistening) 4 gauze swabs 10 x 10cm Order Code: TR EXS 5201 x1 set (WITHOUT TUBE) 13

Tracoe twist & twist Plus Tracheostomy Tubes Key features Unique Tracoetwist swivelling range neck plate features for maximum mobility Manufactured from medical grade polyurethane Neck flange, blue writing: = fenestrated outer cannula Light and flexible for increased comfort Positive locking action Durable and suitable for long term use Thin walls allow maximum air flow Meets all international standards Radio-opaque and sterile 14 Tracoe tracoe twist - increased flexibility, comfort and performance

At last, a tube you and your patients can feel comfortable with! Tracoe twist & twist Plus Tracheostomy Tubes Maximum Mobility Tracoe twist and twist Plus has a unique swivelling neck plate anatomically shaped, moving around 2 axes i.e. moving in a horizontal and vertical direction. This allows the patient to turn his neck freely in all directions in comfort and to reduce pressure problems from movement from the distal end of the tube digging into the tracheal mucosa. The anatomical shaped neck flange ensures a perfect fit onto the neck, providing a major comfort feature. Tracoe twist & twist Plus Tracheostomy Tubes The Tracoe twist and twist Plus tubes are more flexible compared with other styles of plastic tubes this material is light and flexible and with body temperature becomes even more supple contributing to outstanding comfort for the patient. The wall thickness of the tube is much thinner than a standard plastic tube. This allows a greater volume of inspired air to enter the tube. Therefore, the clinician can choose a larger diameter of tube for the patients trachea. Positive locking of the inner cannula is achieved by the Tracoe twist and twist Plus inner cannula in the outer tube housing. The arrow on the 15mm connector indicates correct positioning so confidence is provided that the inner cannula is securely in place particularly important when using with ventilators. High Acceptance Tracoe twist and twist Plus tracheostomy tubes are suitable throughout the life of the tracheostomy from initial theatre use to long term use in the community as they feature weaning caps, which fit over the outer housing; to speaking valves, which of course allows communication to take place a vital motivation for all tracheostomised patients. unique swivelling neckplate The most outstanding feature of Tracoe twist and twist Plus is the anatomically shaped neck flange that moves around two axes: vertically (a) and horizontally (b). The neck strap can be easily attached while the tube is in situ (c). 15

Tracoe twist Tracheostomy Tubes Tracoe twist Tracheostomy Tubes 301 Colour Coding 302 Colour Coding Tracheostomy tube, unfenestrated with low pressure cuff Outer cannula with cuff 2 inner cannulas with 15mm connector (white) Perforated obturator and wide neck strap (see below) Tracoe twist range features Fenestrated tracheostomy tube with low pressure cuff Outer cannula, fenestrated with cuff Inner cannula, fenestrated with 15mm connector Inner cannula with 15mm connector Occlusion cap for 15mm connector Perforated obturator and wide neck strap (see below) Featuring the unique anatomically shaped swivelling neck flange The most outstanding feature of Tracoe twist is the anatomically shaped neck flange that moves around two axes: vertically (a) and horizontally (b). The neck strap can be easily attached while the tube is in situ (c). Neck flange, blue writing: = fenestrated tube Each Tracoe twist tube is supplied with a perforated obturator and a wide adjustable neck strap as well as a tube info card with peel-off stickers on front and back. The neck strap is also available separately. Neck flange, green writing: = unfenestrated tube 16 Tracoe twist See page 21 for accessories and spare parts

featuring the unique anatomically shaped swivelling neck flange Tracoe twist Tracheostomy Tubes 303 Colour Coding 304 Colour Coding Tracheostomy tube Outer cannula 2 inner cannulas with 15mm connector Perforated obturator and wide neck strap (see page 16) Fenestrated tracheostomy tube Outer cannula fenestrated Inner cannula, fenestrated with 15mm connector Inner cannula with 15mm connector Occlusion cap for 15mm connector Perforated obturator and wide neck strap (see page 16) 6 BA Reference numbers and measurements: 301 / 302 / 303 / 304 / 306 5 AB 4 TL 3 OD-OC bf 7 CD 2 OD-OT bc 1 ID-IC Size å ç é Lengths (mm) ë í ID-IC OD-OC bc OD-OC bf è ê BA CD (mm) (mm) (mm) TL AB (O ) (mm) 04 4.0 7.2 8.6 56 63.0 110 14 05 5.0 8.6 10.1 66 73.0 100 16 06 6.0 9.2 10.8 72 79.5 95 20 07 7.0 10.4 12.0 74 80.5 95 24 08 8.0 11.4 12.7 76 83.0 90 28 09 9.0 12.5 14.2 78 88.5 90 30 10 10.0 13.8 15.2 80 89.5 90 32 åid-ic: inside diameter (clear width) at bottom of inner cannula çod-oc bc: outside diameter éod-oc bf: outside diameter of outer cannula behind the flange èlength TL: along centre line from start of neck flange to bottom of tube; êlength AB: length along outer bend from start of neck flange to bottom of tube; ëba: bending angle; ícd: cuff diameter 17

Tracoe twist Tracheostomy Tubes Tracoe twist Tracheostomy Tubes 305 Colour Coding Laryngectomy tube, unfenestrated, cuffless Outer cannula Inner cannula with 15mm connector Inner cannula with grooved low profile connector Perforated obturator and wide neck strap (see page 16) Reference numbers and measurements: 305 See sizing diagram on page 17 Size å ç é Lengths (mm) ë ID-IC OD-OC bc OD-OC bf è ê BA (mm) (mm) (mm) TL AB (O ) 05 5.0 9.0 10.1 47 52 125 06 6.0 9.4 10.8 50 56 120 07 7.0 10.6 12.0 52 59 120 08 8.0 11.6 12.7 56 63 115 09 9.0 12.8 14.2 58 66 108 10 10.0 14.2 15.2 60 70 100 åid-ic: inside diameter (clear width) at bottom of inner cannula çod-oc bc: outside diameter éod-oc bf: outside diameter of outer cannula behind the flange èlength TL: along centre line from start of neck flange to bottom of tube; êlength AB: length along outer bend from start of neck flange to bottom of tube; ëba: bending angle; ícd: cuff diameter The Tracoe twist range of tracheostomy tubes with subglottic suction lines are designed to deliver maximum performance and provide an important tool in the management of ventilator-associated pneumonia (VAP) which is associated with patients in intensive care situations. 306 Colour Coding Tracheostomy tube, unfenestrated with low pressure cuff and subglottic suction line Outer cannula with cuff and subglottic suction line 2 inner cannulas with 15mm connector 2 connectors for suction devices Perforated obturator and wide neck strap (see page 16) Also available in fenestrated version: Ref 888-306 (See page 22) Subglottic Suctioning - Benefits Subglottic suctioning offers the following key benefits: Accumulated subglottic secretions can be suctioned off at the lowest point, in other words, right above the cuff. This reduces the risk of bacterially contaminated secretions entering the lower respiratory tract and the risk of developing aspiration pneumonia. The suction line is integrated into the wall of the tube to avoid any pressure marks in the tracheostoma. Via this line, secretions can be suctioned off. Tracoe twist tracheostomy tubes with subglottic suctioning. Ref 306 / 306-P 18 Tracoe twist See page 21 for accessories and spare parts

Tracoe twist P - Tracheostomy Tubes with atraumatic inserter Tracoe twist P tubes - key features The special feature of the Tracoe twist P tube is the atraumatic insertion system. A unique stepless transition between the inserter tip and the tracheostomy tube is achieved by a collapsible sleeve at the tip of the introducer (fig. 1). The atraumatic inserter is supplied fitted into the tube and should not be removed prior to use. The atraumatic inserter fits exactly into the tube and bears a safety-stop at the neck flange. After the tube with atraumatic inserter is inserted into the trachea the inserter is pulled out. Thereby the silicone sleeve turns down and the inserter can be easily removed (fig. 2). Fig.1 A collapsible sleeve at the introducer tip enables a unique stepless transition between the inserter tip and the patient end of the tube. Fig.2 After the tube with atraumatic inserter is inserted into the trachea the inserter is pulled out. Thereby the silicone sleeve turns down and the inserter can be removed easily. Tracoe twist P Tracheostomy Tubes Tracoe twist P tubes are supplied with the experc percutaneous kits. 301-P Tracoe twist tracheostomy tube, unfenestrated with low pressure cuff and atraumatic inserter Outer cannula with cuff 2 inner cannulas with 15mm connector Atraumatic inserter Sterile lubricating gel Perforated obturator and wide neck strap (see page 16) 302-P Tracoe twist tracheostomy tube, fenestrated with low pressure cuff and atraumatic inserter Outer cannula, fenestrated with cuff Inner cannula with 15mm connector Inner cannula, fenestrated with 15mm connector Occlusion cap Atraumatic inserter Sterile lubricating gel Perforated obturator and wide neck strap (see page 16) For further details, please contact Kapitex Customer Services on 01937 580211 19

Tracoe twist P Tracheostomy Tubes Tracoe twist P - tracheostomy tubes with atraumatic inserter 306-P Tracoe twist tracheostomy tube unfenestrated with low pressure cuff subglottic suction line and atraumatic inserter Outer cannula with cuff and subglottic suction line 2 inner cannulas with 15mm connector 2 connectors for suction devices Atraumatic inserter Reinsertion tube Sterile lubricating gel Perforated obturator and wide neck strap (see page 16) 888-306- P Tracheostomy tube, fenestrated with low pressure cuff and subglottic suction line Outer cannula, fenestrated with cuff and subglottic suction line Inner cannula with 15mm connector Inner cannula, fenestrated with 15mm connector 2 connectors for suction devices Perforated obturator and wide neck strap (see page 16) 5 AB 6 BA 4 TL 3 OD-OC bf Reference numbers and measurements: 301-P / 302-P / 303 / 306-P / 888-306-P See sizing diagram on page 17 Size å ç é Lengths (mm) ë í ID-IC OD-OC bc OD-OC bf è ê BA CD (mm) (mm) (mm) TL AB (O ) (mm) 07 7.0 10.4 12.0 74 80.5 95 24 08 8.0 11.4 12.7 76 83.0 90 28 09 9.0 12.5 14.2 78 88.5 90 30 7 CD 2 OD-OT bc 1 ID-IC åid-ic: inside diameter (clear width) at bottom of inner cannula çod-oc bc: outside diameter éod-oc bf: outside diameter of outer cannula behind the flange èlength TL: along centre line from start of neck flange to bottom of tube; êlength AB: length along outer bend from start of neck flange to bottom of tube; ëba: bending angle; ícd: cuff diameter 20 Tracoe twist

Tracoe twist - Inner Tubes & Accessories 401 501-X Tracoe twist Accessories Inner cannulas, fenestrated, with integrated speaking valve (light blue) 2 units supplied in individual sterile packages The inner cannulas are accessories for twist tubes Ref 302 and 304 Sizes: 04, 05, 06, 07, 08, 09, 10 Spare inner cannulas, unfenestrated, with 15mm connector (white) 10 units supplied in individual sterile packages The inner cannulas are spare parts for twist tubes Ref 301,302, 303, 304 and 306 Sizes: 04, 05, 06, 07, 08, 09, 10 502 Inner cannulas, fenestrated, with grooved low profile connector (light blue) 3 units supplied in individual sterile packages The inner cannulas are accessories for twist tubes Ref 302 and 304 Sizes: 04, 05, 06, 07, 08, 09, 10 506-X Spare inner cannulas, fenestrated, with 15mm connector (light blue) 10 units supplied in individual sterile packages The inner cannulas are spare parts for twist tubes Ref 302, 304 and 888-306 Sizes: 04, 05, 06, 07, 08, 09, 10 507 Inner cannulas, unfenestrated, with grooved low profile connector (white) 3 units supplied in individual sterile packages 516 Occlusion caps (blue) Pack of 5 occlusion caps (blue) The inner cannulas are accessories for twist tube Ref 303 Sizes: 04, 05, 06, 07, 08, 09, 10 21

Tracoe twist & twist Plus Tracheostomy Tubes Ordering information- Tracoe twist tracheostomy tubes Tracoe twist 301 Low pressure cuffed tracheostomy tube not fenestrated TR TRA 1001 4 56 4.0 7.2 TR TRA 1001A 5 66 5.0 8.6 TR TRA 1002 6 72 6.0 9.2 TR TRA 1002A 7 74 7.0 10.4 TR TRA 1003 8 76 8.0 11.4 TR TRA 1003A 9 78 9.0 12.5 TR TRA 1004 10 80 10.0 13.8 Tracoe twist 302 Fenestrated low pressure cuffed tracheostomy tube Tracoe twist 304 Cuffless tracheostomy tube, fenestrated TR TRA 1016 4 56 4.0 7.2 TR TRA 1016A 5 66 5.0 8.6 TR TRA 1017 6 72 6.0 9.2 TR TRA 1017A 7 74 7.0 10.4 TR TRA 1018 8 76 8.0 11.4 TR TRA 1018A 9 78 9.0 12.5 TR TRA 1019 10 80 10.0 13.8 Tracoe twist 306, Low pressure cuffed, not fenestrated with subglottic suction line TR TRA 1006 4 56 4.0 7.2 TR TRA 1006A 5 66 5.0 8.6 TR TRA 1007 6 72 6.0 9.2 TR TRA 1007A 7 74 7.0 10.4 TR TRA 1008 8 76 8.0 11.4 TR TRA 1008A 9 78 9.0 12.5 TR TRA 1009 10 80 10.0 13.8 TR TRA 1051 4 56 4.0 7.2 TR TRA 1052 5 66 5.0 8.6 TR TRA 1053 6 72 6.0 9.2 TR TRA 1054 7 74 7.0 10.4 TR TRA 1055 8 76 8.0 11.4 TR TRA 1055A 9 78 9.0 12.5 TR TRA 1056 10 80 10.0 13.8 Tracoe twist 303 Cuffless tracheostomy tube, not fenestrated TR TRA 1011 4 56 4.0 7.2 TR TRA 1011A 5 66 5.0 8.6 TR TRA 1012 6 72 6.0 9.2 TR TRA 1012A 7 74 7.0 10.4 TR TRA 1013 8 76 8.0 11.4 TR TRA 1013A 9 78 9.0 12.5 TR TRA 1014 10 80 10.0 13.8 Tracoe twist 888-306, Low pressure cuffed, fenestrated with subglottic suction line TR TRA 1079 4 56 4.0 7.2 TR TRA 1080 5 66 5.0 8.6 TR TRA 1081 6 72 6.0 9.2 TR TRA 1082 7 74 7.0 10.4 TR TRA 1083 8 76 8.0 11.4 TR TRA 1084 9 78 9.0 12.5 TR TRA 1085 10 80 10.0 13.8 Tracoe twist tracheostomy tubes with atraumatic inserter Tracoe twist 301-P Low pressure cuffed tracheostomy tube, not fenestrated with atraumatic inserter TR EXT 0107 7 74 7.0 10.4 TR EXT 0108 8 76 8.0 11.4 TR EXT 0109 9 78 9.0 12.5 Tracoe twist 302-P Low pressure cuffed tracheostomy tube, fenestrated with atraumatic inserter TR EXT 0207 7 74 7.0 10.4 TR EXT 0208 8 76 8.0 11.4 TR EXT 0209 9 78 9.0 12.5 22 Tracoe twist

Tracoe twist 306-P Low pressure cuffed tracheostomy tube, not fenestrated with atraumatic inserter TR EXT 0607 7 74 7.0 10.4 TR EXT 0608 8 76 8.0 11.4 TR EXT 0609 9 78 9.0 12.5 Tracoe twist 888-306-P Low pressure cuffed tracheostomy tube, fenestrated with atraumatic inserter TR EXT 8067 7 74 7.0 10.4 TR EXT 8068 8 76 8.0 11.4 TR EXT 8069 9 78 9.0 12.5 Ordering information- Tracoe twist inner tubes & accessories Tracoe twist 401 Fenestrated inner tube with speaking valve. Suits models 302 and 304. Pack of 2 TR TRA 1024 4 56 4.0 * TR TRA 1024A 5 66 5.0 * TR TRA 1025 6 72 6.0 * TR TRA 1025A 7 74 7.0 * TR TRA 1026 8 76 8.0 * TR TRA 1026A 9 78 9.0 * TR TRA 1027 10 80 10.0 * Tracoe twist 506-X Spare inner tube fenestrated with 15mm connector (Blue). Suits models 302 and 304. Pack of 10 TR TRA 1070 4 56 4.0 * TR TRA 1071 5 66 5.0 * TR TRA 1072 6 72 6.0 * TR TRA 1073 7 74 7.0 * TR TRA 1074 8 76 8.0 * TR TRA 1075 9 78 9.0 * TR TRA 1076 10 80 10.0 * Tracoe twist & twist Plus Tracheostomy Tubes Tracoe twist 501-X Spare inner tube with 15mm connector (white). Not fenestrated. Suits all models except 305. Pack of 10 Tracoe twist 507 Inner cannulas, unfenestrated with grooved low profile connector (white). Suits model 303. Pack of 3 TR TRA 1063 4 56 4.0 * TR TRA 1064 5 66 5.0 * TR TRA 1065 6 72 6.0 * TR TRA 1066 7 74 7.0 * TR TRA 1067 8 76 8.0 * TR TRA 1068 9 78 9.0 * TR TRA 1069 10 80 10.0 * TR TRA 1057 4 56 4.0 * TR TRA 1058 5 66 5.0 * TR TRA 1059 6 72 6.0 * TR TRA 1060 7 74 7.0 * TR TRA 1061 8 76 8.0 * TR TRA 1061A 9 78 9.0 * TR TRA 1062 10 80 10.0 * Tracoe twist 502 Spare inner tube with low profile connector (blue), fenestrated. Suits models 302 and 304. Pack of 3 Tracoe twist 516 Occlusion caps 15mm. TR TRA 1046A Pack of 5 TR TRA 1035 4 56 4.0 * TR TRA 1035A 5 66 5.0 * TR TRA 1036 6 72 6.0 * TR TRA 1036A 7 74 7.0 * TR TRA 1037 8 76 8.0 * TR TRA 1037A 9 78 9.0 * TR TRA 1038 10 80 10.0 * For further details, please contact Kapitex Customer Services on 01937 580211 23

Tracoe twist Plus Tracheostomy Tubes Tracoe twist Plus Tracheostomy Tubes Key features Longer version of the well-proven twist tube Greatly reduced wall thickness maximises respiratory airflow Maximum inner lumen - thin walled but stable inner cannula Less outer diameter with more inner lumen New safety locking device for inner tube Highly improved phonation through double fenestration (Ref 312 and 314) Subglottic Suctioning Subglottic suctioning offers the following benefits: Accumulated subglottic secretions can be suctioned off at the lowest point, in other words, right above the cuff. This reduces the risk of bacterially contaminated secretions entering the lower respiratory tract and the risk of developing aspiration pneumonia. The Tracoe twist Plus provides maximum airway flow due to its innovative thinner cannula wall design. This allows the anaesthetist/intensivist to use a larger diameter Tracoe twist Plus compared with standard tubes. Easier phonation Highly improved phonation through double fenestration of 312 and 314: multiple fenestration at the outer bend as well as two additional phonation holes at the inner bend. All Tracoe twist Plus tubes are delivered with inserted inner cannula with pre-installed obturator The suction line is integrated into the wall of the tube to avoid any pressure marks in the tracheostoma. Via this line, secretions can be suctioned off. Tracoe twist Plus tracheostomy tubes with subglottic suctioning. Ref 316 / 316-P Each Tracoe twist Plus tube is supplied with a perforated obturator and a wide adjustable neck strap as well as a tube info card with peel-off stickers on front and back. The neck strap is also available separately. 24 Tracoe twist Plus See page 30 for accessories and spare parts

Tracoe twist Plus - innovative features deliver maximum performance Tracoe twist Plus Tracheostomy Tubes 311 + + + + Colour Coding Colour Coding 312 Tracoe twist Plus tracheostomy tube, unfenestrated with low pressure cuff Outer cannula with cuff 2 inner cannulas with 15mm connector Perforated obturator and wide neck strap (see page 24) Tracoe twist Plus tracheostomy tube, double fenestrated with low pressure cuff Outer cannula double fenestrated with cuff Inner cannula with 15mm connector Inner cannula double fenestrated with 15mm connector Occlusion cap for 15mm connector Perforated obturator and wide neck strap (see page 24) twist Plus Reference numbers and measurements: 311 / 312 / 313 / 314 / 316 5 AB 6 BA 4 TL 3 OD-OC bf Size å ç é Lengths (mm) ë í ID-IC OD-OC bc OD-OC bf è ê BA CD (mm) (mm) (mm) TL AB (O ) (mm) 07 7.0 9.8 10.1 85 91 100 26 08 8.0 10.8 11.1 88 95 100 28 09 9.0 11.8 12.1 90 99 100 30 10 10.0 12.8 13.1 92 102 100 32 7 CD 2 OD-OT bc 1 ID-IC åid-ic: inside diameter (clear width) at bottom of inner cannula çod-oc bc: outside diameter éod-oc bf: outside diameter of outer cannula behind the flange èlength TL: along centre line from start of neck flange to bottom of tube; êlength AB: length along outer bend from start of neck flange to bottom of tube; ëba: bending angle; ícd: cuff diameter 25

Tracoe twist Plus Tracheostomy Tubes Tracoe twist Plus - Tracheostomy Tubes 313 314 + + Colour Coding + + Colour Coding Tracoe twist Plus tracheostomy tube, unfenestrated, cuffless Outer cannula 2 inner cannulas with 15mm connector Perforated obturator and wide neck strap (see page 24) Tracoe twist Plus tracheostomy tube, double fenestrated, cuffless Outer cannula double fenestrated Inner cannula with 15mm connector Inner cannula double fenestrated with 15mm connector Occlusion cap for 15mm connector Perforated obturator and wide neck strap (see page 24) See pages 28-29 for sizing chart and ordering information 316 + + Colour Coding Tracoe twist Plus tracheostomy tube, unfenestrated, with low pressure cuff and subglottic suction line Outer cannula with cuff and subglottic suction line 2 inner cannulas with 15mm connector 2 connectors for suction devices Perforated obturator and wide neck strap (see page 24) 26 Tracoe twist Plus

Tracoe twist Plus - innovative features deliver maximum performance 888-316 Tracoe twist Plus tracheostomy tube double fenestrated, with low pressure cuff and subglottic suction line Outer cannula with cuff and subglottic suction line 2 inner cannulas with 15mm connector 2 connectors for suction devices Perforated obturator and wide neck strap (see page 24) Tracoe twist Plus Tracheostomy Tubes Tracoe twist Plus P with atraumatic inserter (used with Experc set) 311-P Tracoe twist Plus tracheostomy tube, unfenestrated with low pressure cuff and atraumatic insertion system Outer cannula with cuff 2 inner cannulas with 15mm connector Atraumatic insertion system Sterile lubricating gel Perforated obturator and wide neck strap (see page 24) 312-P Tracoe twist Plus tracheostomy tube, double fenestrated with low pressure cuff and atraumatic insertion system Outer cannula, double fenestrated with cuff Inner cannula with 15mm connector Inner cannula, double fenestrated with 15mm connector Occlusion cap Atraumatic insertion system Sterile lubricating gel Perforated obturator and wide neck strap (see page 24) 27

Tracoe twist Plus Tracheostomy Tubes Tracoe twist Plus P with atraumatic inserter (used with Experc set) 316-P Tracoe twist Plus tracheostomy tube, unfenestrated with low pressure cuff, subglottic suction line and atraumatic insertion system Outer cannula with cuff and subglottic suction line 2 inner cannulas with 15mm connector 2 connectors for suction devices Atraumatic insertion system Sterile lubricating gel Perforated obturator and wide neck strap (see page 24) 888-316-P Tracoe twist Plus tracheostomy tube double fenestrated, with low pressure cuff subglottic suction line and atraumatic inserter Outer cannula with cuff and subglottic suction line 2 inner cannulas with 15mm connector 2 connectors for suction devices Atraumatic insertion system Sterile lubricating gel Perforated obturator and wide neck strap (see page 24) Tracoe twist Plus - Sizing chart Reference numbers and measurements: 311-P / 312-P / 316-P 6 BA Size å ç é Lengths (mm) ë í ID-IC OD-OC bc OD-OC bf è ê BA CD (mm) (mm) (mm) TL AB (O ) (mm) 07 7.0 9.8 10.1 85 91 100 26 08 8.0 10.8 11.1 88 95 100 28 09 9.0 11.8 12.1 90 99 100 30 10 10.0 12.8 13.1 92 102 100 32 5 AB 4 TL 3 OD-OC bf åid-ic: inside diameter (clear width) at bottom of inner cannula çod-oc bc: outside diameter éod-oc bf: outside diameter of outer cannula behind the flange èlength TL: along centre line from start of neck flange to bottom of tube; êlength AB: length along outer bend from start of neck flange to bottom of tube; ëba: bending angle; ícd: cuff diameter 7 CD 2 OD-OT bc 1 ID-IC 28 Tracoe twist Plus

Ordering information- Tracoe twist Plus tracheostomy tubes Tracoe twist Plus 311 With HVLP cuff, non fenestrated including 2 inner tubes and 1 introducer TR TRA 5117 7 85 7.0 9.8 TR TRA 5118 8 88 8.0 10.8 TR TRA 5119 9 90 9.0 11.8 TR TRA 5120 10 92 10.0 12.8 Tracoe twist Plus 312 With HVLP cuff, double fenestrated including 2 inner tubes and 1 introducer TR TRA 5127 7 85 7.0 9.8 TR TRA 5128 8 88 8.0 10.8 TR TRA 5129 9 90 9.0 11.8 TR TRA 5130 10 92 10.0 12.8 Tracoe twist Plus 314 Uncuffed, double fenestrated including 2 inner tubes and 1 introducer TR TRA 5147 7 85 7.0 9.8 TR TRA 5148 8 88 8.0 10.8 TR TRA 5149 9 90 9.0 11.8 TR TRA 5150 10 92 10.0 12.8 Tracoe twist Plus 316 Low pressure cuffed with subglottic suction line and atraumatic inserter, non fenestrated including 2 inner tubes and 1 introducer TR TRA 5167 7 85 7.0 9.8 TR TRA 5168 8 88 8.0 10.8 TR TRA 5169 9 90 9.0 11.8 TR TRA 5170 10 92 10.0 12.8 Tracoe twist Plus Tracheostomy Tubes Tracoe twist Plus 313 Uncuffed, non fenestrated including 2 inner tubes and 1 introducer TR TRA 5137 7 85 7.0 9.8 TR TRA 5138 8 88 8.0 10.8 TR TRA 5139 9 90 9.0 11.8 TR TRA 5140 10 92 10.0 12.8 Tracoe twist Plus 888-316 Low pressure cuffed with subglottic suction line and atraumatic inserter, double fenestrated including 2 inner tubes and 1 introducer TR TRA 8167 7 85 7.0 9.8 TR TRA 8168 8 88 8.0 10.8 TR TRA 8169 9 90 9.0 11.8 TR TRA 8170 10 92 10.0 12.8 Tracoe twist Plus tracheostomy tubes with atraumatic inserter Tracoe twist Plus 311-P Low pressure cuffed, unfenestrated tracheostomy tube with atraumatic insertion system TR EXT 1107 7 85 7.0 9.8 TR EXT 1108 8 88 8.0 10.8 TR EXT 1109 9 90 9.0 11.8 TR EXT 1110 10 92 10.0 12.8 Tracoe twist Plus 316-P Low pressure cuffed, unfenestrated tracheostomy tube with subglottic suction line and atraumatic insertion system TR EXT 1607 7 85 7.0 9.8 TR EXT 1608 8 88 8.0 10.8 TR EXT 1609 9 90 9.0 11.8 TR EXT 1610 10 92 10.0 12.8 Tracoe twist Plus 312-P Low pressure cuffed, double fenestrated tracheostomy tube with atraumatic insertion system TR EXT 1207 7 85 7.0 9.8 TR EXT 1208 8 88 8.0 10.8 TR EXT 1209 9 90 9.0 11.8 TR EXT 1210 10 92 10.0 12.8 Tracoe twist Plus 888-316-P Low pressure cuffed, double fenestrated tracheostomy tube with subglottic suction line and atraumatic insertion system TR EXT 8167 7 85 7.0 9.8 TR EXT 8168 8 88 8.0 10.8 TR EXT 8169 9 90 9.0 11.8 TR EXT 8170 10 92 10.0 12.8 29

Tracoe twist Plus Accessories Tracoe twist Plus - Spare Parts & Accessories 521-X Spare inner cannulas, unfenestrated with 15mm connector 10 units supplied in individual sterile packages. The inner cannulas are spare parts for all twist Plus models. Sizes: 07, 08, 09, 10 523-X Spare inner cannulas, double fenestrated with 15mm connector (blue) 10 units supplied in individual sterile packages. The inner cannulas are spare parts for twist Plus tubes Ref: 312, 312P, 888-316, 888-316. Sizes: 07, 08, 09, 10 TR TRA 5217 7 85 7.0 * TR TRA 5218 8 88 8.0 * TR TRA 5219 9 90 9.0 * TR TRA 5220 10 92 10.0 * TR TRA 5237 7 85 7.0 * TR TRA 5238 8 88 8.0 * TR TRA 5239 9 90 9.0 * TR TRA 5240 10 92 10.0 * 516 Occlusion caps (blue) Pack of 5 occlusion caps 15mm(blue) TR TRA 1046A Pack of 5 30 Tracoe twist Plus

Notes Notes 31

Tracoe vario Tracheostomy Tubes Key features Adjustable Tracoetwist neck flange range allows features accurate placement and security A spring mechanism lets the flange slide easily to a new position and prevents any pressure being exerted Neck flange, on the blue trachea writing: during adjustment = fenestrated outer cannula A length marker ensures the exact setting Neck flange features two pliable wings that can be rotated either together or independently to provide the most comfortable setting Available in 5 styles with spiral reinforcement, cuffed and uncuffed and non reinforced plastic with x-ray contrast line, cuffed and uncuffed 32 Tracoe vario - a new milestone in tracheostomy

A flexible tube with a patented variably adjustable neck flange Tracoe vario Tracheostomy Tubes The unique Tracoe vario Tracoe vario - the flexible tube with the patented adjustable neck flange. By means of a practical locking mechanism, the neck flange can be moved and adjusted individually to any patient. Tracoe vario Tracheostomy Tubes A length marker ensures the exact positioning of the neck flange in preparation to change tubes (a).the flange will move by depressing the grey side panels on the flange. The flange is fixed immediately after it is released. Additionally the neck flange will be securely locked by pulling up the orange lever (b). A Perfect Fit The pliable wings on the flange can be adjusted independently of one another (c). This provides additional possibilities for meeting the unique anatomical requirements of each patient. Tracoe vario tracheostomy tubes are made of clear plastic and come in several versions. Reinforced with metal spiral, or non reinforced (with an x-ray contrast line) with or without low pressure cuff, with subglottic suction line and in an extra long version. Now with subglottic suction Accumulated subglottic secretions can be suctioned off at the lowest point, in other words, right above the cuff. This reduces the risk of bacterially contaminated secretions entering the lower respiratory tract and the risk of developing aspiration pneumonia. The suction line is integrated into the wall of the tube to avoid any pressure marks in the tracheostoma. Via this line, secretions can be suctioned off. Tracoe vario tracheostomy tubes with subglottic suctioning. Ref 470 / 470-P / 471 numerous adaptabilities (a) A length marker ensures the exact positioning of the neck flange in preparation to change tubes (b) As an optional precaution the neck flange can be securely locked by pulling up the orange lever system (c) pliable wings on the flange can be adjusted independently of one another. This helps to meet the unique anatomical requirements of each patient. 33

Tracoe vario Tracheostomy Tubes Tracoe vario Tracheostomy Tubes 450 Wire reinforced tracheostomy tube with adjustable neck flange and low pressure cuff Cannula with 15mm connector, wire reinforced, with cuff and scale Obturator and wide neck strap (see page 37) Colour Coding 455 Colour Coding Spiral-reinforced tracheostomy tube, cuffless with adjustable neck flange Cannula with 15mm connector, wire reinforced, with scale Obturator and wide neck strap (see page 37) extra long 460 Colour Coding Tracheostomy tube with adjustable neck flange and low pressure cuff Cannula with 15mm connector, cuff, X-ray contrast line and scale Obturator and wide neck strap (see page 37) 451 XL vario XL extra long, wire reinforced tracheostomy tube with adjustable neck flange and low pressure cuff Cannula with 15mm connector, wire reinforced with cuff and scale Obturator and wide neck strap (see page 37) Colour Coding 34 Tracoe vario

Tracoe vario Tracheostomy Tubes - with Subglottic Suction Subglottic suction line - key benefits Accumulated subglottic secretions can be suctioned off at the lowest point, in other words, right above the cuff. This reduces the risk of bacterially contaminated secretions entering the lower respiratory tract and the risk of developing aspiration pneumonia. The suction line is integrated into the wall of the tube to avoid any pressure marks in the tracheostoma. Via this line, secretions can be suctioned off. The variably adjustable neck flange with rotating wings permits universal adjustment to any neck anatomy (e.g. thick necks, post operative oedma, asymmetrical necks). Ref 450-P / 451-P / 470-P / 471-P Tracoe vario tracheostomy tubes with atraumatic insertion system. For details refer to page 36. Tracoe vario Tracheostomy Tubes extra long 470 Colour Coding Vario tracheostomy tube with adjustable neck flange, low pressure cuff and subglottic suction line Cannula with 15mm connector, cuff, X-ray contrast line, scale and subglottic suction line 2 connectors for suction pump Obturator and wide neck strap (see page 37) 471 XL Colour Coding vario extra long tracheostomy tube with adjustable neck flange, low pressure cuff and subglottic suction line Cannula with 15mm connector, cuff, X-ray contrast line, scale and subglottic suction line 2 connectors for suction pump Obturator and wide neck strap (see page 37) For sizing information see page 39 35

Tracoe vario Tracheostomy Tubes Tracoe vario P Tracheostomy Tubes - with atraumatic inserter 450-P Tracoe vario tracheostomy tube, wire reinforced with adjustable neck flange, low pressure cuff and atraumatic insertion system Cannula with 15mm connector, wire reinforced with cuff, scale and atraumatic insertion system Sterile lubricating gel Obturator and wide neck strap (see page 37) extra long 451-P Tracoe vario XL tracheostomy tube, extra long, wire reinforced with adjustable neck flange, low pressure cuff and atraumatic insertion system Cannula extra long with 15mm connector, wire reinforced with cuff, scale and atraumatic insertion system Sterile lubricating gel Obturator and wide neck strap (see page 37) extra long 470-P Tracoe vario tracheostomy tube with subglottic suction, adjustable neck flange, low pressure cuff and atraumatic insertion system Cannula with 15mm connector, cuff, X-ray contrast line, scale, subglottic suction line and atraumatic insertion system 2 connectors for suction devices Sterile lubricating gel Obturator and wide neck strap (see page 37) 471-P Tracoe vario XL tracheostomy tube, extra long with subglottic suction, adjustable neck flange, low pressure cuff and atraumatic insertion system Cannula extra long with 15mm connector, cuff, X-ray contrast line, scale, subglottic suction line and atraumatic insertion system 2 connectors for suction devices Sterile lubricating gel Obturator and wide neck strap (see page 37) 36 Tracoe vario

Ordering information- Tracoe vario tracheostomy tubes Tracoe vario 450 cuffed, wire reinforced Wire reinforced tracheostomy tube with adjustable neck flange and low pressure cuff TR TRA 3001 6 70 6.0 8.2 TR TRA 3002 7 80 7.0 9.7 TR TRA 3003 8 90 8.0 11.2 TR TRA 3004 9 100 9.0 12.3 TR TRA 3005 10 110 10.0 13.7 TR TRA 3006 11 120 11.0 14.8 Tracoe vario 460 cuffed, not reinforced Tracheostomy tube with low pressure cuff and adjustable neck flange TR TRA 3013 6 70 6.0 8.2 TR TRA 3014 7 80 7.0 9.7 TR TRA 3015 8 90 8.0 11.2 TR TRA 3016 9 100 9.0 12.3 TR TRA 3017 10 110 10.0 13.7 TR TRA 3018 11 110 11.0 14.8 Tracoe vario Tracheostomy Tubes Tracoe vario 451 extra long, cuffed, wire reinforced Extra long tracheostomy tube, wire reinforced with low pressure cuff and adjustable neck flange TR TRA 3025 7 104 7.0 9.7 TR TRA 3026 8 123 8.0 11.2 TR TRA 3027 9 126 9.0 12.3 TR TRA 3028 10 135 10.0 13.7 Tracoe vario 470 tracheostomy tube, cuffed, not wire reinforced with subglottic suction line Tracheostomy tube with low pressure cuff and adjustable neck flange TR TRA 3029 7 80 7.0 9.7 TR TRA 3030 8 90 8.0 11.2 TR TRA 3031 9 100 9.0 12.3 TR TRA 3032 10 110 10.0 13.7 Tracoe vario 455 uncuffed, wire reinforced Spiral reinforced tracheostomy tube with adjustable neck flange TR TRA 3007 6 70 6.0 8.2 TR TRA 3008 7 80 7.0 9.7 TR TRA 3009 8 90 8.0 11.2 TR TRA 3010 9 100 9.0 12.3 TR TRA 3011 10 110 10.0 13.7 TR TRA 3012 11 110 11.0 14.8 Tracoe vario 471 extra long, cuffed, not reinforced with subglottic suction line Extra long tracheostomy tube with low pressure cuff, adjustable neck flange and subglottic suction line. TR TRA 3033 7 104 7.0 9.7 TR TRA 3034 8 123 8.0 11.2 TR TRA 3035 9 126 9.0 12.3 TR TRA 3036 10 135 10.0 13.7 Tracoe vario - the flexible tube with the unique variably adjustable neck flange Each Tracoe vario tube is supplied with an obturator and a wide adjustable neck strap as well as a tube info card with peel-off stickers on front and back. The neck strap is also available separately. For further details, please contact Kapitex Customer Services on 01937 580211 37

Tracoe vario Tracheostomy Tubes Ordering information- Tracoe vario with atraumatic inserter Tracoe vario 450-P Wire reinforced with adjustable neck flange, low pressure cuff and atraumatic insertion system TR EXT 4507 7 80 7.0 9.7 TR EXT 4508 8 90 8.0 11.2 TR EXT 4509 9 100 9.0 12.3 Tracoe vario 451-P Extra long, wire reinforced with adjustable neck flange, low pressure cuff and atraumatic insertion system Tracoe vario 470-P With adjustable neck flange, low pressure cuff, subglottic suction line and atraumatic insertion system TR EXT 4708 8 90 8.0 11.2 TR EXT 4709 9 100 9.0 12.3 Tracoe vario 471-P Extra Long with adjustable neck flange, low pressure cuff, subglottic suction line and atraumatic insertion system TR EXT 4517 7 104 7.0 9.7 TR EXT 4518 8 123 8.0 11.2 TR EXT 4519 9 126 9.0 12.3 TR EXT 4718 8 123 8.0 11.2 TR EXT 4719 9 126 9.0 12.3 Notes 38 Tracoe vario

Tracoe vario Sizing information Reference numbers and measurements: 450 / 455 and 460 Size åid çod Lengths (mm) êba ëcd (mm) (mm) A C B étl èab (O ) (mm) 06 6.0 8.2 30 28 12 70 76 100 23 07 7.0 9.7 33 32 15 80 86 100 26 08 8.0 11.2 35 35 20 90 97 100 28 09 9.0 12.3 38 35 27 100 106 100 30 10 10.0 13.7 38 37 35 110 120 100 32 11 11.0 14.8 38 37 35 110 121 100 34 Reference numbers and measurements: 450-P / 470-P Size åid çod Lengths (mm) êba ëcd (mm) (mm) A C B étl èab (O ) (mm) 07 7.0 9.7 33 32 15 80 86 100 26 08 8.0 11.2 35 35 20 90 97 100 28 09 9.0 12.3 38 35 27 100 106 100 30 Tracoe vario Tracheostomy Tubes Reference numbers and measurements: 470 Size åid çod Lengths (mm) êba ëcd (mm) (mm) A C B étl èab (O ) (mm) 07 7.0 9.7 33 32 15 80 86 100 26 08 8.0 11.2 35 35 20 90 97 100 28 09 9.0 12.3 38 35 27 100 106 100 30 10 10.0 13.7 38 37 35 110 120 100 32 Reference numbers and measurements: 451-P / 471-P Size åid çod Lengths (mm) êba ëcd (mm) (mm) A C B étl èab (O ) (mm) 07 7.0 9.7 35 36 33 104 110 100 26 08 8.0 11.2 37 46 40 123 128 100 28 09 9.0 12.3 38 46 42 126 134 100 30 Reference numbers and measurements: 451 and 471 Extra Long Size åid çod Lengths (mm) êba ëcd (mm) (mm) A C B étl èab (O ) (mm) 07 7.0 9.7 35 36 33 104 110 100 26 08 8.0 11.2 37 46 40 123 128 100 28 09 9.0 12.3 38 46 42 126 134 100 30 10 10.0 13.7 38 52 45 135 146 100 32 C 5 BA B 3 TL A 6 CD 1 ID 2 OD åid: inside diameter (clear width) at bottom of cannula çod: outside diameter at bottom of cannula étl: length along centre line èab: length along outer bend êba: bending angle ëcd: cuff diameter (Ref 450 and 460) 39

Tracoe comfort Tracheostomy Tubes Key features Light, Tracoetwist flexible, soft range and pliable features - harmless to tissue, adapting easily to the trachea Made from implant tested medical grade PVC with rounded Neck ends flange, to prevent blue writing: mucosal damage = fenestrated outer cannula Do not need to be removed for X-ray or cobalt therapy Low profile fittings enables the user to wear tracheostomy filters and protectors in comfort Available in a variety of styles and sizes as standard - customised sizes or lengths available on request 40 Tracoe comfort - the ideal range for long-term use

A range of comfortable, flexible, uncuffed tracheostomy tubes Tracoe comfort Tracheostomy Tubes Lightweight, Soft and Flexible Tracoe comfort tracheostomy tubes are made of clear medicalgrade polymer material which makes them both especially soft and very lightweight. They do not have to be removed for X-ray or cobalt therapy. A Tracoe comfort tube weighs only about one third the weight of a silver tube of the same size. Because they are transparent it is also very easy to ensure that they are perfectly clean. Tracoe comfort Tracheostomy Tubes As Comfortable as Possible As the name suggests, Tracoe comfort tubes are designed to be as comfortable as possible for permanent wearers after tracheostomy or laryngectomy. Their discreet appearance is an added benefit. Many Models and Sizes Every tube model comes in many different sizes and lengths with and without speaking valves. Kapitex can supply special customised tubes for any individual - any size or length can be made to ensure maximum comfort for the wearer. For more information contact Kapitex. Superb quality, featuring Neat Fenestrations Swivel Valve Detachable Speaking Valve 41

Tracoe comfort Tracheostomy Tubes Tracoe comfort tracheostomy tubes 101 Tube without inner cannula Cannula Wide neck strap For acute tracheostomy and emergency care applications 102 Tube, unfenestrated with inner cannula Outer cannula One inner cannula Wide neck strap For permanent wearers Tracoe comfort features Fenestrations Safety is a prime concern, and the design of the fenestrations within the Tracoe tubes are neat and smooth. Instead of one large fenestration, these tubes have a group of small holes which will help prevent granulation into the fenestration. Please note all Tracoe tubes with speaking valves are supplied with fenestrations, but tubes can be supplied without fenestrations by special order. Speaking valves Speaking valves are available in Types 103 and 104 as illustrated.type 103 with a detachable valve Type 104 with a swivel valve which can be moved sideways both types are supplied with a spare inner cannula which can be used at night when the speech facility is not in use. Lubrication We recommend lubrication with water soluble lubricant, e.g. Glycerin BP. A couple of drops onto the inner cannula will allow smooth entry and easy removal of the inner cannula. Extra inner cannulas We are able to supply extra inner cannulas, and speaking valves with all styles of Tracoe comfort tubes. Please contact Kapitex Customer Services for prices and details. Each Tracoe comfort tube is supplied with an adjustable neck strap as well as a tube info card with peel-off stickers on front and back. The neck strap is also available separately. 42 Tracoe comfort

Tracoe comfort - long term tracheostomy tubes Tracoe comfort Tracheostomy Tubes 102-D Tube with inner cannula Outer cannula Two inner cannulas Wide neck strap For permanent wearers 103 Tube, fenestrated with slide on speaking valve, Type A Outer cannula, fenestrated One inner cannula, fenestrated with slide-on silver valve type A One plain inner cannula Wide neck strap For tracheostomised patients with fully or partially intact larynx, for speaking. Bending angle 6 AB 5 TL 2 OD-OC bc 1 ID-OC 3 OD-OC bf åid-oc: inside diameter (clear width) at bottom of outer cannula çod-oc bc: outside diameter at bottom of outer cannula éod-oc bf: outside diameter of outer cannula behind the flange èid-ic: inside diameter at bottom of inner cannula; êlength TL: length along centre line from start of neck flange to bottom of tube; ëlength AB: length along outer bend (greatest length) Reference numbers and measurements: 101 / 102 / 102-D / 103 / 104 / 104-A / 105 / 105-D Size å ç é è Lengths (mm) ID-OC OD-OC bc OD-OC bf ID-IC ê ë (mm) (mm) (mm) (mm) TL AB 03 3.5 4.8 6.4 2.6 42 46 04 4.0 5.6 7.3 3.2 50 55 05 5.0 6.7 8.7 4.0 52 57 06 6.0 7.6 10.0 4.8 54 60 07 7.0 8.8 10.5 5.8 57 65 08 8.0 10.0 11.3 6.8 61 70 09 9.0 11.4 12.6 7.6 65 75 10 10.0 12.4 13.7 8.7 74 85 11 11.0 13.1 15.0 9.7 76 87 12 12.0 14.2 16.2 10.8 78 90 The bending angle is 90 in comfort tubes 43

Tracoe comfort Tracheostomy Tubes Tracoe comfort tracheostomy tubes 104 Tube, fenestrated with swivel speaking valve, Type B Outer cannula, fenestrated One inner cannula, fenestrated with swivel valve type B One plain inner cannula Wide neck strap For tracheostomised patients with fully or partially intact larynx, for speaking. 104-A Tube, fenestrated with swivel speaking valve, Type B Outer cannula, fenestrated One inner cannula, fenestrated with swivel valve type B One inner cannula with 15mm connector One plain inner cannula Wide neck strap For tracheostomised patients with fully or partially intact larynx, for speaking. Customisation Product variants can be made to order to optimise the functionality and wearing comfort for patients with complex anatomical and physiological conditions. Please contact Kapitex Customer Services for prices and details. Each Tracoe comfort tube is supplied with an adjustable neck strap as well as a tube info card with peel-off stickers on front and back. The neck strap is also available separately. Please refer to pages 43 and 45 for numbers and measurements for Ref 101 to 105-D 44 Tracoe comfort For further details, please contact Kapitex Customer Services on 01937 580211

Tracoe comfort - long term tracheostomy tubes Tracoe comfort Tracheostomy Tubes 105 Tube, unfenestrated with 15mm connector Outer cannula Inner cannula with 15mm connector Wide neck strap 105-D Tube, unfenestrated with 15mm connector Outer cannula Two inner cannulas with 15mm connector Wide neck strap Bending angle 6 AB 5 TL 2 OD-OC bc 1 ID-OC 3 OD-OC bf åid-oc: inside diameter (clear width) at bottom of outer cannula çod-oc bc: outside diameter at bottom of outer cannula éod-oc bf: outside diameter of outer cannula behind the flange èid-ic: inside diameter at bottom of inner cannula; êlength TL: length along centre line from start of neck flange to bottom of tube; ëlength AB: length along outer bend (greatest length) Reference numbers and measurements: 101 / 102 / 102-D / 103 / 104 / 104-A / 105 / 105-D Size å ç é è Lengths (mm) ID-OC OD-OC bc OD-OC bf ID-IC ê ë (mm) (mm) (mm) (mm) TL AB 03 3.5 4.8 6.4 2.6 42 46 04 4.0 5.6 7.3 3.2 50 55 05 5.0 6.7 8.7 4.0 52 57 06 6.0 7.6 10.0 4.8 54 60 07 7.0 8.8 10.5 5.8 57 65 08 8.0 10.0 11.3 6.8 61 70 09 9.0 11.4 12.6 7.6 65 75 10 10.0 12.4 13.7 8.7 74 85 11 11.0 13.1 15.0 9.7 76 87 12 12.0 14.2 16.2 10.8 78 90 The bending angle is 90 in comfort tubes 45

Tracoe comfort Tracheostomy Tubes Tracoe comfort tracheostomy tubes - Extra Long 202 Extra long tube, unfenestrated with inner cannula Outer cannula, extra long One plain inner cannula Wide neck strap For permanent wearers and patients with tracheal stenosis. 202-D Extra long tube, unfenestrated with inner cannulas Outer cannula, extra long Two plain inner cannulas Wide neck strap For permanent wearers and patients with tracheal stenosis. Bending angle 5 TL 1 ID-OC 6 AB 2 OD-OC bc 3 OD-OC bf åid-oc: inside diameter (clear width) at bottom of outer cannula çod-oc bc: outside diameter at bottom of outer cannula éod-oc bf: outside diameter of outer cannula behind the flange èid-ic: inside diameter at bottom of inner cannula; êlength TL: length along centre line from start of neck flange to bottom of tube; ëlength AB: length along outer bend (greatest length) Reference numbers and measurements: 202 / 202-D / 204 / 204-A / 205 / 215 Size å ç é è Lengths (mm) ID-OC OD-OC bc OD-OC bf ID-IC ê ë (mm) (mm) (mm) (mm) TL AB 05 5.0 6.6 9.0 4.0 85 92 06 6.0 7.7 9.8 5.0 87 95 07 7.0 8.7 10.5 6.0 93 100 08 8.0 10.5 12.2 6.7 96 105 09 9.0 11.5 13.0 7.5 100 110 10 10.0 12.5 14.5 8.8 104 115 11 11.0 13.5 15.5 9.2 108 120 12 12.0 14.4 16.4 10.0 112 125 The bending angle is 90 in comfort tubes 46 Tracoe comfort

Tracoe comfort tracheostomy tubes - Extra Long Tracoe comfort Tracheostomy Tubes 204 Extra long tube, fenestrated with swivel speaking valve Type B Outer cannula, extra long, fenestrated One inner cannula, fenestrated with swivel valve type B One plain inner cannula Wide neck strap 204-A Extra long tube, fenestrated with swivel speaking valve Type B Outer cannula, extra long, fenestrated One inner cannula, fenestrated with swivel speaking valve type B One plain inner cannula Inner cannula with 15mm connector Wide neck strap Customisation Product variants can be made to order to optimise the functionality and wearing comfort for patients with complex anatomical and physiological conditions. Please contact Kapitex Customer Services for prices and details. Each Tracoe comfort tube is supplied with an adjustable neck strap as well as a tube info card with peel-off stickers on front and back. The neck strap is also available separately. For further details, please contact Kapitex Customer Services on 01937 580211 47

Tracoe comfort Tracheostomy Tubes Tracoe comfort tracheostomy tubes - Extra Long 205 Extra long tube, unfenestrated with 15mm connector Outer cannula, extra long One inner cannula with 15mm connector Wide neck strap 215 Extra long tube, fenestrated with 15mm connector Outer cannula, extra long, fenestrated One inner cannula One inner cannula unfenestrated with 15mm connector Wide neck strap Customised tubes 1) PLEASE NOTE: Customised tubes must be ordered on templates provided by Kapitex or from the Kapitex website. They must be signed by a doctor or authorised nursing staff, accompanied by an official hospital order number. 2) We recommend that clinicians and nursing staff refer to inner diameter of inner cannula - length - and outside diameter of outer cannula when selecting a tube. Each Tracoe comfort tube is supplied with an adjustable neck strap as well as a tube info card with peel-off stickers on front and back. The neck strap is also available separately. Please refer to page 46 for numbers and measurements for Ref 205 and 215 3) Spare inner cannulas for the Tracoe comfort range must be ordered at the same time as ordering the tube, up to a maximum of 2 inner cannulas. They cannot be supplied afterwards as they are made at the same time as the comfort tube. Please note all tube length measurements are taken on the mid-line 48 Tracoe comfort

Ordering information - Tracoe comfort tracheostomy tubes Tracoe comfort 101, single cannula tube Tracoe comfort tracheostomy tube, unfenestrated, without inner tube Order number Size Length* I.D. of outer O.D. of outer TR TRA 0001 3 42 3.5 4.8 TR TRA 0002 4 50 4.0 5.6 TR TRA 0003 5 52 5.0 6.7 TR TRA 0004 6 54 6.0 7.6 TR TRA 0005 7 57 7.0 8.8 TR TRA 0006 8 61 8.0 10.0 TR TRA 0007 9 65 9.0 11.4 TR TRA 0008 10 74 10.0 12.4 TR TRA 0009 11 76 11.0 13.1 TR TRA 0010 12 78 12.0 14.2 Tracoe comfort 102 tube not fenestrated Tracoe comfort tracheostomy tube, unfenestrated, with one plain inner cannula Order number Size Length* I.D. of outer O.D. of outer TR TRA 0011 3 42 3.5 4.8 TR TRA 0012 4 50 4.0 5.6 TR TRA 0013 5 52 5.0 6.7 TR TRA 0014 6 54 6.0 7.6 TR TRA 0015 7 57 7.0 8.8 TR TRA 0016 8 61 8.0 10.0 TR TRA 0017 9 65 9.0 11.4 TR TRA 0018 10 74 10.0 12.4 TR TRA 0019 11 76 11.0 13.1 TR TRA 0020 12 78 12.0 14.2 Tracoe comfort 102-D, tube, unfenestrated Tracoe comfort tracheostomy tube, unfenestrated, with two plain inner tubes Order number Size Length* I.D. of outer O.D. of outer TR TRA 0095 3 42 3.5 4.8 TR TRA 0096 4 50 4.0 5.6 TR TRA 0097 5 52 5.0 6.7 TR TRA 0098 6 54 6.0 7.6 TR TRA 0099 7 57 7.0 8.8 TR TRA 0100 8 61 8.0 10.0 TR TRA 0101 9 65 9.0 11.4 TR TRA 0102 10 74 10.0 12.4 TR TRA 0103 11 76 11.0 13.1 TR TRA 0104 12 78 12.0 14.2 Tracoe comfort 103 tube, fenestrated with slide on speaking valve A Tracoe comfort tracheostomy tube with two inner tubes, one fenestrated with speaking valve A and one plain unfenestrated inner tube Order number Size Length* I.D. of outer O.D. of outer TR TRA 0039 3 42 3.5 4.8 TR TRA 0040 4 50 4.0 5.6 TR TRA 0041 5 52 5.0 6.7 TR TRA 0042 6 54 6.0 7.6 TR TRA 0043 7 57 7.0 8.8 TR TRA 0044 8 61 8.0 10.0 TR TRA 0045 9 65 9.0 11.4 TR TRA 0046 10 74 10.0 12.4 TR TRA 0047 11 76 11.0 13.1 TR TRA 0048 12 78 12.0 14.2 Tracoe comfort 104 tube, fenestrated with swivel speaking valve B Tracoe comfort with two inner cannulas, one fenestrated with speaking valve type B and one unfenestrated plain inner tube. Order number Size Length* I.D. of outer O.D. of outer TR TRA 0049 3 42 3.5 4.8 TR TRA 0050 4 50 4.0 5.6 TR TRA 0051 5 52 5.0 6.7 TR TRA 0052 6 54 6.0 7.6 TR TRA 0053 7 57 7.0 8.8 TR TRA 0054 8 61 8.0 10.0 TR TRA 0055 9 65 9.0 11.4 TR TRA 0056 10 74 10.0 12.4 TR TRA 0057 11 76 11.0 13.1 TR TRA 0058 12 78 12.0 14.2 Tracoe comfort 104-A tube, fenestrated with swivel speaking valve B Tracoe comfort with three inner cannulas, one plain unfenestrated, one with 15mm connector, unfenestrated and one with speaking valve type B, fenestrated. Order number Size Length* I.D. of outer O.D. of outer TR TRA 0069 3 42 3.5 4.8 TR TRA 0070 4 50 4.0 5.6 TR TRA 0071 5 52 5.0 6.7 TR TRA 0072 6 54 6.0 7.6 TR TRA 0073 7 57 7.0 8.8 TR TRA 0074 8 61 8.0 10.0 TR TRA 0075 9 65 9.0 11.4 TR TRA 0076 10 74 10.0 12.4 TR TRA 0077 11 76 11.0 13.1 TR TRA 0078 12 78 12.0 14.2 Tracoe comfort Tracheostomy Tubes 49

Tracoe comfort Tracheostomy Tubes Ordering information - Tracoe comfort tracheostomy tubes Tracoe comfort 105 tube, unfenestrated Tracoe comfort tracheostomy tube, unfenestrated, with inner cannula with15mm connector Order number Size Length* I.D. of outer O.D. of outer TR TRA 0029 3 42 3.5 4.8 TR TRA 0030 4 50 4.0 5.6 TR TRA 0031 5 52 5.0 6.7 TR TRA 0032 6 54 6.0 7.6 TR TRA 0033 7 57 7.0 8.8 TR TRA 0034 8 61 8.0 10.0 TR TRA 0035 9 65 9.0 11.4 TR TRA 0036 10 74 10.0 12.4 TR TRA 0037 11 76 11.0 13.1 TR TRA 0038 12 78 12.0 14.2 Tracoe comfort 105-D tube, unfenestrated Tracoe comfort tracheostomy tube, unfenestrated, with two inner cannulas with 15mm connector Tracoe comfort 202-D extra long tube, unfenestrated Tracoe comfort extra long tracheostomy tube, unfenestrated, with two plain inner cannulas Order number Size Length* I.D. of outer O.D. of outer TR TRA 0105 5 85 5.0 6.6 TR TRA 0106 6 87 6.0 7.7 TR TRA 0107 7 93 7.0 8.7 TR TRA 0108 8 96 8.0 10.5 TR TRA 0109 9 100 9.0 11.5 TR TRA 0110 10 104 10.0 12.5 TR TRA 0111 11 108 11.0 13.5 TR TRA 0112 12 112 12.0 14.4 Tracoe comfort 204 extra long tube, fenestrated with swivel speaking valve type B Tracoe comfort extra long tracheostomy tube, fenestrated, with two inner cannulas, one fenestrated with swivel speaking valve type B, and one plain inner cannula. Order number Size Length* I.D. of outer O.D. of outer TR TRA 0059 3 42 3.5 4.8 TR TRA 0060 4 50 4.0 5.6 TR TRA 0061 5 52 5.0 6.7 TR TRA 0062 6 54 6.0 7.6 TR TRA 0063 7 57 7.0 8.8 TR TRA 0064 8 61 8.0 10.0 TR TRA 0065 9 65 9.0 11.4 TR TRA 0066 10 74 10.0 12.4 TR TRA 0067 11 76 11.0 13.1 TR TRA 0068 12 78 12.0 14.2 Order number Size Length* I.D. of outer O.D. of outer TR TRA 0113 5 85 5.0 6.6 TR TRA 0114 6 87 6.0 7.7 TR TRA 0115 7 93 7.0 8.7 TR TRA 0116 8 96 8.0 10.5 TR TRA 0117 9 100 9.0 11.5 TR TRA 0118 10 104 10.0 12.5 TR TRA 0119 11 108 11.0 13.5 TR TRA 0120 12 112 12.0 14.4 TR TRA 0121 13 116 13.0 15.4 TR TRA 0122 14 122 14.0 16.4 Tracoe comfort 202 extra long tube, unfenestrated Tracoe comfort extra long tracheostomy tube, unfenestrated, with one plain inner cannula Order number Size Length* I.D. of outer O.D. of outer TR TRA 0021 5 85 5.0 6.6 TR TRA 0022 6 87 6.0 7.7 TR TRA 0023 7 93 7.0 8.7 TR TRA 0024 8 96 8.0 10.5 TR TRA 0025 9 100 9.0 11.5 TR TRA 0026 10 104 10.0 12.5 TR TRA 0027 11 108 11.0 13.5 TR TRA 0028 12 112 12.0 14.4 Tracoe comfort 204A extra long tube, fenestrated with swivel speaking valve type B Tracoe comfort extra long tracheostomy tube, fenestrated with three inner cannula, one plain inner tube, one fenestrated with speaking valve B and one with 15mm connector Order number Size Length* I.D. of outer O.D. of outer TR TRA 0079 5 85 5.0 6.6 TR TRA 0080 6 87 6.0 7.7 TR TRA 0081 7 93 7.0 8.7 TR TRA 0082 8 96 8.0 10.5 TR TRA 0083 9 100 9.0 11.5 TR TRA 0084 10 104 10.0 12.5 TR TRA 0085 11 108 11.0 13.5 TR TRA 0086 12 112 12.0 14.4 50 Tracoe comfort

Tracoe comfort 205 extra long tube, unfenestrated Tracoe comfort extra long tracheostomy tube, unfenestrated, with one inner cannula with 15mm connector Order number Size Length* I.D. of outer O.D. of outer TR TRA 0087 5 85 5.0 6.6 TR TRA 0088 6 87 6.0 7.7 TR TRA 0089 7 93 7.0 8.7 TR TRA 0090 8 96 8.0 10.5 TR TRA 0091 9 100 9.0 11.5 TR TRA 0092 10 104 10.0 12.5 TR TRA 0093 11 108 11.0 13.5 TR TRA 0094 12 112 12.0 14.4 Tracoe comfort 215 extra long tube, fenestrated Tracoe comfort extra long tracheostomy tube, fenestrated, with two inner tubes with 15mm connector one fenestrated and one unfenestrated. Order number Size Length* I.D. of outer O.D. of outer TR TRA 0123 7 93 7.0 8.7 TR TRA 0124 8 96 8.0 10.5 TR TRA 0125 9 100 9.0 11.5 Tracoe comfort Tracheostomy Tubes Notes 51

Tracoe mini Tracheostomy Tubes Key features Light, flexible, soft and pliable - harmless to tissue, adapting easily to the trachea The thin walls ensure flexibility, smoothness and support, retaining its shape at all times The obturator features an easy to grip handle allowing for the mini tube to be inserted easily and securely Smooth tips on the end of the tube and obturator help provide smooth insertion Available in a wide range of sizes 52 Tracoe mini - small in size, big in performance

Specifically developed for newborn, infants and children Tracoe mini Neonatal & Paediatric Tracheostomy Tubes Tracoe mini Tracheostomy Tubes The Smaller, the Greater Tracoe mini has been especially developed for newborns, infants and children. They are particularly soft and equipped with a neck flange with a slanted bottom, providing the tube with an optimised and atraumatic fit. These tubes have very thin walls to meet the special requirements of use in small patients. However, they reliably retain their shape at all times. The smooth, funnelshaped inner design of the 15mm connector allows an easy insertion of suction catheters. Easy and Reliable The special obturator is extremely practical. The grip on its end makes sure that the tube can be easily and reliably inserted despite its small size. Neck straps and compresses are also available to match. Anatomically Optimum Solutions Tracoe mini is available in 12 different sizes: 4 for neonates and 8 for paediatric use. 53

Tracoe mini Tracheostomy Tubes Tracoe mini tracheostomy tubes - Neonatal & Paediatric 350 Colour Coding 355 Colour Coding Tracheostomy tube, uncuffed for neonates Cannula Obturator and neck strap (shown below) Tracheostomy tube, uncuffed for children Cannula Obturator and neck strap (shown below) Tracoe mini 350 tracheostomy tube for neonates Tracoe mini tracheostomy tube including cannula, obturator and neck strap Tracoe mini 355 tracheostomy tube for children Tracoe mini tracheostomy tube including cannula, obturator and neck strap TR TRA 4001 2.5 30 2.5 3.6 TR TRA 4002 3.0 32 3.0 4.3 TR TRA 4003 3.5 34 3.5 5.0 TR TRA 4004 4.0 36 4.0 5.6 Tracoe mini colour coding The colour coding is conspicuously printed on each box. This helps you organise your inventory and quickly and reliably locate the right tube. TR TRA 4005 2.5 32 2.5 3.6 TR TRA 4006 3.0 36 3.0 4.3 TR TRA 4007 3.5 40 3.5 5.0 TR TRA 4008 4.0 44 4.0 5.6 TR TRA 4009 4.5 48 4.5 6.3 TR TRA 4010 5.0 50 5.0 7.0 TR TRA 4011 5.5 55 5.5 7.6 TR TRA 4012 6.0 62 6.0 8.4 Customisation Each Tracoe mini tube is supplied with an obturator and a wide adjustable neck strap as well as a tube info card with peel-off stickers on front and back. The neck strap is also available separately. Product variants Ref 355: Product variants can be made to order to optimise the functionality and wearing comfort and also for patients with complex anatomical and physiological conditions. Product variations have green writing on the neck flange. 54 Tracoe mini

Tracoe mini tracheostomy tubes - Accessories Reference numbers and measurements: 350 Size åid çod Lengths (mm) êba (mm) (mm) A C B étl èab (O ) 2.5 2.5 3.6 6 22 2 30 32 120 3.0 3.0 4.3 7 23 2 32 34 120 3.5 3.5 5.0 8 23 3 34 37 120 4.0 4.0 5.6 9 24 3 36 40 120 Reference numbers and measurements: 355 Size åid çod Lengths (mm) êba (mm) (mm) A C B étl èab (O ) 2.5 2.5 3.6 8 22 2 32 34 120 3.0 3.0 4.3 10 24 2 36 39 120 3.5 3.5 5.0 12 25 3 40 43 120 4.0 4.0 5.6 14 27 3 44 48 120 4.5 4.5 6.3 16 28 4 48 52 120 5.0 5.0 7.0 18 28 4 50 55 120 5.5 5.5 7.6 20 30 5 55 60 120 6.0 6.0 8.4 22 35 5 62 67 120 A 2 OD 1 ID C 5 BA 3 TL åid: inside diameter (clear width) of tube çod: outside diameter of tube étl: length along centre line from start of neck flange to bottom of tubeèab: length along outer bend from start of neck flange to bottom of tube êba: bending angle B Tracoe mini Tracheostomy Tubes Prevents obstruction of the patient end of the tube. Fits all mini tubes. 356 Tracoe mini extension piece Extension piece Disconnecting aid (wedge) Product information card with peel-off sticker on front and back Order No: TR TRA 4013 55

Passy-Muir Speaking Valves Passy-Muir Tracheostomy and ventilator speaking valves The ONLY Speaking Valves indicated for ALL of the following uses: Communication Improves Swallow May Reduce Aspiration Ventilator Application Facilitates Secretion Management Improves Oxygenation Improves Olfaction Expedites Weaning and Decannulation Restores Positive Airway Pressure Interchangeability Between Tracheostomy and Ventilator Use Facilitates Infection Control Key features Patented no-leak closure system Improves oxygenation and swallow Restores positive airway pressure Non protruding speaking valve Interchangeable between tracheostomy and ventilator use Facilitates infection control Passy-Muir Speaking Valves are the ultimate in Tracheostomy speaking valves, providing many clinical benefits due to their unique no-leak design. We offer several types of Passy-Muir Valve to enable the medical team to offer the best suitable solution for the individual. Positive Closure a patented closed position No Leak design The No Leak design of the Passy-Muir Valves (PMVs) means that the valve is always in a closed position until the patient inhales. The valve opens easily with less than normal inspiratory pressures and closes automatically at the end of the inspiratory cycle without air leak and without patient expiratory effort. Closed System Unlike open position speaking valves, the closed position of the PMV allows the patient to create a positive airway pressure and restores the patient to a more normal closed respiratory system. The closed system also creates a protective column of air in the tracheostomy tube which resists secretions from moving up the tube and occluding the valve. Instead, secretions may be coughed up around the tube and expectorated or suctioned from the mouth. All Passy-Muir Valves (PMV) Have a closed position No Leak design that restores a closed respiratory system. PMV Closed Position No Leak Design Maintains a column of air in the tracheostomy tube and redirects airflow and secretions up the trachea. All Other Speaking Valves Have an open position design that causes air leakage during exhalation. We have available for further reading and reference, an excellent Passy-Muir clinical pack which we recommend members of the Healthcare team to read. This comprehensive guide clearly highlights the benefits of the valves and illustrates many aspects of the management of tracheostomised patients (Adult as well as Paediatric.) 56 Passy-Muir

Passy-Muir tracheostomy & ventilator speaking valves Passy-Muir Speaking Valves PMV 005 PMV 005 (White) tracheostomy speaking valve The PMV 005 is the original PMV and is more commonly used by non-ventilator dependent persons. PMV 007 PMV 007 (Aqua) tracheostomy and ventilator speaking valve Designed to fit inside adult disposable ventilator tubing. The bright colour makes it easier to see while in the ventilator tubing. Use of an adapter may be needed to adapt the PMV to paediatric or various closed suctioning systems Ordering Information Dimensions: I.D. 15mm O.D. 23mm Order No: TR PMV 0001 Ordering Information Dimensions: I.D. 15mm O.D. 22mm Order No: TR PMV 0002 PMV 2000 PMV 2000 (Clear) Low profile - lower resistance valve Lightweight and smaller than the original PMVs. Designed to be clear and less visible for the more ambulatory patient. PMV 2001 PMV 2001 (Purple) Low profile - lower resistance valve Identical to the PMV 2000 except for its colour. This valve is bright purple to facilitate staff awareness and monitoring of patients while using the PMV. Ordering Information Dimensions: I.D. 15mm O.D. 23mm Order No: TR PMV 1002 Ordering Information Dimensions: I.D. 15mm O.D. 23mm Order No: TR PMV 1003 For further details, please contact Kapitex Customer Services on 01937 580211 57

Passy-Muir Speaking Valves featuring the unique patented closed position no leak design PMA 2000 PMA 2000 Valve O 2 adapter Allows for easy inhalation of low flow supplemental oxygen and humidity through the Low Profile Resistance PMV 2000 Series Valves. The Passy-Muir Valve O2 Adapter is small, lightweight, clear in colour and snaps onto both the PMV 2000 (Clear) and PMV 2001 (Purple) Tracheostomy and Ventilator Speaking Valves and is easily removed when not in use. Oxygen is delivered in front of the diaphragm of the PMV to avoid complications associated with devices that provide continuous flow behind the diaphragm of a speaking valve which may include air trapping, drying of secretions and possible cilia damage. PMV Secure-It PMV Secure-It The PMV 2000 and PMV 2001 are designed with a small ring that allows the new PMV Secure-It to attach from the PMV to the tube holder to prevent valve loss. Ordering Information Dimensions: I.D. 15mm O.D. 23mm Order No: TR PMV 1005 Ordering Information Order No: TR PMV 1004 T.O.M. tracheostomy tube observation model An anatomical model for instructors and clinicians. Ideal for hands-on demonstration, training of skills necessary for tracheostomy care and discussion of tracheostomy and nasogastric tube placement issues. Tracheostomy T.O.M. is a portable, durable polyurethane model mounted on a clear, acrylic platform that depicts a midsaggital view of the nasal cavity with nose, oral cavity, pharynx, trachea and upper oesophagus of a tracheostomised adult. A stoma is provided in the lower neck area to allow for demonstration of the effect of various aspects of tracheostomy care and tracheostomy placement issues. The nose is open allowing insertion and placement of a suction catheter or nasogastric tube. The flexible tracheoesophageal wall allows for demonstration of the effects of an overinflated tracheostomy tube cuff on the oesophagus. Ordering Information Dimensions: Approximately 11 x 6 x 1/2 on a base. Comes with hard shell carrying case with protective foam insert. TR PMV 1001 Tracheostomy OBS Model T.O.M. 58 Passy-Muir

Moore Long Term Tracheostomy Tubes Allows you to adjust or cut to individual size in a clinical situation The Moore tracheostomy tube is an extra long silicone tracheostomy tube with an inner cannula. This flexible tube is designed to conform to individual anatomies. It is one of the few tubes available which can be adjusted/ cut down to size in a clinical situation. Produced from radio-opaque medical grade silicone the tube offers an inert and non-wetting surface which aids in reducing both crusting and clotting. Moore Long Term Tracheostomy Tubes Supplied sterile: with an outer cannula, inner cannula, 15mm connector and tracheostomy holder as well as obturator. Supplied with outer cannula and inner cannula, 15mm connector and tracheostomy holder and obturator. Key features Extra length all silicone inner cannula Radio-opaque Inert and non-wetting surface Available in 3 sizes Ordering information Moore long-term tracheostomy tube Long term tracheostomy tube with outer and inner cannula, 15mm connector, holder and obturator Application Ideal in the following areas: Provides a secondary airway Acute laryngotracheal injuries To support intrathoracic tracheal stomas Tracheal stenosis TR MTT 0001 6.0 115 6.5 11 TR MTT 0002 8.0 115 7.5 12 TR MTT 0003 10.0 115 8.5 13 Accessories Order number Size Description TR MTT 1001 6.0 Inner Cannula 15mm Adaptor Pack of 2 TR MTT 1002 6.0 Inner Cannula Low Profile Pack of 2 TR MTT 1003 6.0 Inner Cannula Obturator Pack of 2 TR MTT 2001 8.0 Inner Cannula 15mm Adaptor Pack of 2 TR MTT 2002 8.0 Inner Cannula Low Profile Pack of 2 TR MTT 2003 8.0 Inner Cannula Obturator Pack of 2 TR MTT 3001 10.0 Inner Cannula 15mm Adaptor Pack of 2 TR MTT 3002 10.0 Inner Cannula Low Profile Pack of 2 TR MTT 3003 10.0 Inner Cannula Obturator Pack of 2 Moore Tracheostomy Tubes 59

Silver Tracheostomy Tubes Silver Tracheostomy Tubes Key features Highest quality solid sterling silver Thin walls allow maximum airflow Economical long term use Non protruding speaking valve Supplied with small and rounded introducer for comfort Customised service available High quality solid sterling silver tracheostomy tubes manufactured to British Standards The standard British silver tracheostomy tube. Made from 100% sterling silver, the Silver Negus tubes are supplied with outer cannula, inner cannula with speaking valve, spare inner cannula and introducer. Silver tubes are often seen as an economical long term tube and has the benefit of allowing maximum airflow into the airway due to its ultra thin walls. 60 Silver Tubes A customised service from Kapitex is available on application. Contact Customer Services on 01937 580211

With built-in speaking valve and introducer without fenestration Kapitex have for many years been supplying silver tracheostomy tubes into the NHS and to overseas customers. The main model of tube supplied is the Negus style this comprises a built in speaking valve. Kapitex only sources from the key silver tube manufacturer in the UK. ALL components are suitable for medical applications and are to British Standards. Please note: The silver tubes are produced from sterling silver. Quality is paramount - we do not supply silver plated or non silver metal tubes. Silver Tracheostomy Tubes The Negus Silver tube set comprises of the following: Outer tube with neck flange Inner tube with speaking valve incorporated A spare non-valved inner cannula Introducer Design features 1) The introducer is small and rounded to ensure a comfortable introduction of the tube into the tracheostoma. 2) The neck flange is designed to ensure that movement of the neck is comfortable without the tube digging in. 3) The speaking valve is situated in the inner cannula housing, this enables the tube to lie flat against the neck. The benefit is there is no protrusion of the speaking valve unlike some systems which have speaking valves sticking out on the tube adaptor. 4) One of the key benefits of a silver tube is the thin wall thickness (within the overall diameter). Allowing maximum airflow into the airway, unlike some thicker plastic or silicone tubes. 5) Silver tubes are often seen as an economical long term tube. 6) A customised service from Kapitex is available on application. components of the Negus silver tube Colour Coding Ordering information Order number FG Length* O.D.** (mm) (mm) TR KAP 0006 16 48 5.3 TR KAP 0007 18 53 6.0 TR KAP 0008 20 56 6.7 TR KAP 0009 22 60 7.3 TR KAP 0010 24 62 8.0 TR KAP 0011 26 64 8.7 TR KAP 0012 28 68 9.3 TR KAP 0013 30 72 10.0 TR KAP 0014 32 74 10.7 TR KAP 0015 34 76 11.3 TR KAP 0016 36 82 12.0 TR KAP 0017 38 86 12.7 TR KAP 0018 40 90 13.3 the smooth rounded introducer Inner tubes shown with and without speaking valve * Length = measurement taken from the back of the neck flange to the tip of the tube on the outer surface ** OD measured on straight shaft 61

Kapitex Stoma Suds Kapitex Stoma Studs simple and effective comfort and flexibility Simple and effective Available in four sizes Comfortable to wear CE marked Autoclavable single patient use Ordering information Stoma studs produced from radio-opaque medical grade silicone available in the following four sizes: Order number I.D. O.D. Length (mm) (mm) (mm) TR SST 0001 8.0 10.5 17.8 TR SST 0002 10.0 12.5 17.8 TR SST 0003 12.0 14.5 17.8 TR SST 0004 14.0 16.5 17.8 Available in four stoma sizes 8, 10, 12 and 14mm. Supplied as singles. The Stoma Studs are simple devices to help keep the stoma open. Kapitex Stoma Studs have the right balance between comfort and flexibility, and give the necessary support to the stoma opening. Stoma Studs are produced from radio-opaque medical grade silicone. Carefully designed, offering no sharp or rigid edges and comfortable to wear, the rounded, moulded edges ensure that the stud is easily placed into the stoma without discomfort. A hole has been made in the outer flange to allow a thread to be attached and pinned to clothing, to prevent ingestion and loss if expelled through coughing. 62 Kapitex Stoma Studs

Kapitex Laryngectomy Tubes Kapitex Laryngectomy Tubes offer the following major features and benefits: Produced from medical grade silicone. Soft yet supportive for the stoma and the trachea. Smooth rounded edges for extra comfort and safety. Customising service available (the tubes can be made to specific lengths, up to 60mm in length). The Kapitex Laryngectomy Tube can be fenestrated for voice prosthesis users. Comprehensive diameters and lengths available to give you the best choice. Competitively priced. Supplied individually wrapped, clean with twill tape. Single patient use product. CE marked AVAILABLE ON FP10 PRESCRIPTION Kapitex Laryngectomy Tubes ideal for introduction on the ward and ENT clinic Ordering information Kapitex Laryngectomy Tube Laryngectomy tube produced from medical grade silicone available in the following sizes: ID OD ID OD ID OD ID OD Length 8mm 10.5mm 10mm 12.5mm 12mm 14.5mm 14mm 16.5mm Length 20mm TR VNT 0820 TR VNT 1020 TR VNT 1220 TR VNT 1420 30mm TR VNT 0830 TR VNT 1030 TR VNT 1230 TR VNT 1430 40mm TR VNT 0840 TR VNT 1040 TR VNT 1240 TR VNT 1440 50mm TR VNT 0850 TR VNT 1050 TR VNT 1250 TR VNT 1450 60mm TR VNT 0860 TR VNT 1060 TR VNT 1260 TR VNT 1460 Kapitex Laryngectomy Tubes 63

Trachi-Hold Tracheostomy Tube Holders Trachi-Hold Key features Secure positioning of tube on neck Easily and quickly adjusted Soft and flexible materials Avoids soreness and discomfort Trachi-Hold Tube Holders have been designed for ease of use and comfort. Using flexible and soft materials the skin area on the neck is kept free from soreness and discomfort. Tracheostomy tube holders Trachi-Hold is easy to use and ensures that tracheostomy tubes are kept securely in place. Three sizes are available. Trachi-Hold Large Designed to provide secure positioning of the tracheostomy tube. Two piece neckband produced from a laminate of foam and brushed nylon. Trachi-Hold attaches to the tracheostomy tube flanges with Velcro fasteners. Easily fitted and quickly adjusted. Ordering Information Dimensions: Width 26mm. Length (adjustable) up to 470mm. TR ACC 0012 Large Pack of 10 Trachi-Hold Small Kapitex also offer a smaller version as an ideal size for Produced from a laminate of polyurethane foam and Trachi-Hold is soft to the skin reducing risk of sore Trachi-Hold features secure Velcro fastenings. children brushed nylon neck line. Ordering Information Dimensions: Width 17mm. Length (adjustable) up to 350mm. TR ACC 0014 Small Pack of 10 AVAILABLE ON FP10 PRESCRIPTION Trachi-Hold - successfully used in intensive care units, ENT wards, clinics and community settings Trachi-Hold Mini Specially for babies and small children Overcomes pressure sores from traditional twill ties Provides gentle, comfortable yet secure tracheostomy tube holding. Ordering Information Dimensions: Width 17mm. Maximum Length 190mm. TR ACC 0030 Mini Pack of 10 Trachi-Hold - For extra security, comfort and convenience Trachi-Hold features soft, flexible and rounded edges 64 Trachi-Hold

Trachi-Dress Sterile tracheostomy dressing Dedicated to keep the tracheal stoma area dry and make tracheostomy management easier Trachi-Dress is a major advance over traditional gauze and foam style dressings. Trachi-Dress absorbs mucus reducing the risk of mucus sitting on the skin underneath a tracheostomy tube. Because mucus is absorbed into the body of the dressing away from the skin skin excoriation is minimised and the risk of an infected area developing is reduced. Trachi-Dress has additional benefits Absorbs mucus and keeps the skin dry Low profile does not raise tracheostomy tubes from the neck Non adhesive dressing Soft rounded edges smooth to the skin Keyhole cut for easy fitting around the tracheostomy tube shaft Available in two sizes, small and large the small being suitable for children Individually wrapped in peel-pouch and sterile Cost effective when compared with more expensive dressings because unit price is lower Trachi-Dress provides greater absorbency! The viscose absorbent layer provides absorbency of up to 800%. Layer one Polyethylene film non adherent layer Layer two Viscose absorbent layer Layer three Viscose/ polyethylene backing layer AVAILABLE ON FP10 PRESCRIPTION Trachi-Dress is the brand leader and has been successfully used in hospital and community settings for many years The construction of Trachi-Dress The dressing comprises of three layers, each of which plays an important role. LAYER ONE This skin contact layer is non-adherent. The polyethylene film helps prevent tissue adhering to the dressing thereby aiding removal when changing the dressing. This layer also helps keep the skin dry. Trachi-Dress Tracheostomy Dressings LAYER TWO This is the absorbent layer. The middle section is constructed of viscose to ensure maximum absorbency, through capillary action which draws mucus away from the skin. LAYER THREE This viscose/polyethylene combination provides an effective seal which retains mucus within the body of the dressing. With skin contact layer - absorption layer and backing layer Ordering information Dimensions: Small Trachi-Dress: : 82mm W x 60mm D x 2mm thick. Large Trachi-Dress : 100mm W x 82mm D x 2mm thick. TR DRE 0001 Small Pack of 20 TR DRE 0002 Large Pack of 20 Trachi-Dress 65

Trachi-Dress F Sterile Foam Tracheostomy Dressings Trachi-Dress F Sterile foam tracheostomy / cannula dressing Key features Quicker absorption speed 66 Better retention High density Balanced moisture vapour transmission rate Kapitex is pleased to extend the Trachi-Dress range by introducing the latest polyurethane foam dressing technology. The Trachi-Dress F Tracheostomy/Cannula Dressing has been specifically formulated as a dressing, with specific characteristics to encourage an optimal healing environment. Although Trachi-Dress F is aimed at the tracheostoma site and the neck region, its construction and performance lends itself to the following areas: Acute wound (donor site) Pressure ulcers Skin flaps Dry wounds Meshed grafts and bio-engineered tissue Chronic wounds Burns to the neck region Trachi-Dress F the high performance polyurethane foam dressing Quicker absorption speed It is important that the dressing absorbs secretions quickly. If there is poor absorption and the area around the stoma is too moist it is possible that masceration of tissue would start. Better retention Trachi-Dress F Foam retains within the body of the dressing the secretions/residue far better than gauze or sponge dressings. Low retention would mean a leakage of secretions onto the skin not helping the healing process as is often the case with sponge style dressings. Trachi-Dress F - due to its pore size construction - retains and absorbs well to encourage a better healing environment. Peel A good foam wound dressing should not stick to the wound surface when it is changed daily. Due to its surface wound contact layer, Trachi-Dress F has a higher peel factor to help reduce adhesion to the skin, thereby making it less painful or damaging upon removal. Trachi-Dress F has been specially formulated with specific characteristics to encourage an optimal, moist healing environment

Surface/Cross Section comparison Trachi-Dress F Dressing A Dressing B Dressing C Surface layer Cross Section What makes Trachi-Dress F outperform other dressings? Trachi-Dress F Sterile Foam Tracheostomy Dressings Trachi-Dress F has the same construction throughout the dressing. The skin contact layer and the body of the dressing are identical - unlike competitors brands High Density Construction Absorption and retention are key factors of a successful tracheostomy dressing due to its high density and the vast number of pores the Trachi-Dress F dressings ability to absorb and retain is much enhanced when compared with other dressings. Trachi-Dress F is constructed from high density polyurethane foam. The key difference between Trachi- Dress F and key competitors is the pore size of the material. See the comparison cross section/surface diagrams above. Research has shown that pore size of the skin contact layer as well as the body of the dressing is key to providing a successful healing environment. 1.30 1.19 0.72 0.73 0.71 Competitors dressing multi - layered construction Ordering information Dimensions: 100mm W x 82mm D x 5mm thick TR DRF 1002 Pack of 10 Trachi-Dress F high density construction allows greater absorbency 0.15 0.07 0.14 Trachi-Dress F Product A Product B Product C Retention (g/cm 2 ) Absorption (g/cm 2 ) Comparison of Absorption and Retention performance of Trachi-Dress F when compared with leading competitors brands 67

Tracheostomy Management Voiceline tracheostomy speaking valve The Voiceline Tracheostomy Speaking Valve is a one way valve which is fitted to a 15mm connector on a Tracheostomy tube. The valve works in the following way on aspiration, air opens the valve and enters the trachea on expiration the valve is closed and air is diverted into the upper airway via the vocal cords (assuming they are mobile) allowing voicing to take place. The Voiceline Speaking Valve is an economical low cost device it is designed for short term use. When fitted, used and cleaned in accordance with the instructions (provided). The valve will give 10-14 days satisfactory service before replacement is necessary. Single patient use. TR VSV 0001 Voiceline tracheostomy speaking valve Pack of 2 Please Note For longer term Speaking Valve use, and for patients on ventilators who require speaking valves, we recommend the Passy-Muir range of Speaking Valves. See pages 56-58. Please contact Customer Services for our comprehensive educational and product information pack on this range. Tracheostomymanagement Trachi-Wipe tracheostomy skin wipes AVAILABLE ON FP10 PRESCRIPTION Trachi-Wipe skin wipes have been specially formulated for neck breathers to help protect the skin around the stoma and tube site from secretions. Less aggressive than conventional alcohol soaked skin wipes which cause coughing or discomfort due to the inhalation of alcohol fumes. Helps to reduce skin irritation as using the wipe provides a protective layer upon the skin. Simple to use - open sachet, wipe around the stoma area, wait a few moments to ensure dry, then apply dressing if required. Non sticky to touch when dry. Kapitex Trachi-Case The Trachi-Case is a useful aid to keep the patients Tracheostomy requisites together. The case allows for placing tube, cleaning products, dressings and all essentials in a handy carry case. The pack can then be moved with the patient throughout the Hospital and for eventual discharge. Record labels included in the case indicate what tubes and equipment the individual has. A very useful nursing aid. LA NNZ 3001 Trachi-Wipe skin wipes Pack of 30 TR ACC 0019 Trachi-Case only (Contents not supplied) 68 Tracheostomy management

dedicated tracheostomy management aids from Kapitex Trachi-Swab tracheostomy tube cleaning swabs Available in three sizes, these cleaning swabs are ideal for cleaning all PVC/PUC and silicone tracheostomy and laryngectomy tubes. The soft smooth heads of the swabs will not scratch or damage the internal tube surface. The smaller size swab is better suited for Paediatric tubes. When used with cleaning solutions the swabs will help to remove build up of mucus and keep the tube surfaces clean. AVAILABLE ON FP10 PRESCRIPTION Tracheostomy Management TR SWB 0150 Small Head Tracheostomy Pack of 50 Cleaning Swabs TR SWB 0250 Large Head Tracheostomy Pack of 50 Cleaning Swabs TR SWB 3050 Extra Large Head Pack of 50 Tracheostomy Cleaning Swabs tracheostomy tube Cleaning Fluid tracheostomy tube Cleaning Kit This specially formulated fluid is a convenient way to keep tubes and inner cannulas clean and fresh. One measure of concentrated fluid (5ml) in a ratio of 1:20 will ensure that the tubes will be free of mucus. It is important to rinse and dry the tubes after soaking in the cleaning fluid. 250ml bottle (complete with measure). TR ACC 0020 Tracheostomy Tube Cleaning Fluid 250ml bottle Kapitex offers a specially formulated cleaning powder which helps to keep tubes clean and fresh. The powder contains phosphate and detergent which lifts off and breaks down mucus. A solution is made up by putting the powder in the spare container and adding water. The tracheostomy tubes are kept in this solution for 30 minutes, then rinsed thoroughly with clean water. Management of tracheostomy tubes becomes easier when using the Cleaning Kit and through regular usage ensures that the tubes remain free of particle build up. TR ACC 0005 Cleaning Kit Complete TR ACC 0011 Cleaning Kit Refill Only TR ACC 0021 Cleaning Basket Only 69

Tracheostomy Management AVAILABLE ON FP10 PRESCRIPTION Kapi-Gel tracheostoma spacer Ideal for difficult stoma anatomy - providing cushioning behind the tracheostomy tube. Acts as a cushion behind the Tracheostomy tube flange/neckplate. Due to its transparency, Kapi-Gel is not noticeable around the stoma Kapi-Gel promotes skin care around the stoma and helps reduce soreness around the stoma and tube site. May help to reduce mucus leakage around the tracheostomy tube. Kapi-Gel is a tacky laminated silicone gel available in two thicknesses 3mm and 5mm and in two hole dimensions 8mm and 12mm. Spacer diameter 43mm. tracheostomy tube Cleaning Brushes Kapitex Cleaning Brushes are used to ensure that the outer and inner tubes are kept free of dry mucus and debris. Available in four sizes, 8, 10, 12, and 14mm diameter, in packs of two. Brush head length 90mm. The brushes are produced with nylon bristles, spirally bound in stainless steel and moulded into a plastic handle. The brush head is rounded to help reduce the risk of scratching tube surfaces. NB: These brushes are not suitable for Tracoe PVC tubes or silicone tubes. Ordering Information Available in packs of 10. LA TNG 2008 Kapi-Gel THIN 3mm 8mm Pack of 10 LA TNG 2012 Kapi-Gel THIN 3mm 12mm Pack of 10 LA TNG 4008 Kapi-Gel THICK 5mm 8mm Pack of 10 LA TNG 4012 Kapi-Gel THICK 5mm 12mm Pack of 10 AVAILABLE ON FP10 PRESCRIPTION Order Code O.D. Colour Code (mm) TR ACC 0001 8 Orange Pack of 2 TR ACC 0002 10 Blue Pack of 2 TR ACC 0003 12 Purple Pack of 2 TR ACC 0004 14 Green Pack of 2 hand held Cuff Pressure Device This device helps clinicians to prevent damage to tracheal mucosa by monitoring cuff pressures on tracheostomy tubes. It is very important to have the safe sealing pressures in cuffs so as (a) not to cause pressure problems on the Tracheal Mucosa and (b) to ensure a safe seal to help prevent aspiration during swallow. The face of the gauge is clearly marked in green with a safe pressure zone of 16-24cms H 2 0 and an area indicated in red where pressure in cuffs would be deemed to be higher than recommended. To be used in conjunction with tube manufacturers inflatable cuff guidelines. TR EQU 1100 Cuff Pressure Control Device (hand held) 70 Tracheostomy management