Passy-Muir Tracheostomy and Ventilator Speaking …

1 Touching LivesandAdvancingPatient CareThroughEducationPassy- muir Tracheostomy andVentilator Speaking ValveResource Tracheostomy and Ventilator Speaking ValvesTABLE OF CONTENTS , David muir .. of the Passy-Muir valves (PMV) .. Valve Products .. 1A. PMV 005 (White) .. 1B. PMV 007 (Aqua) .. 2C. PMV 2000 (Clear) .. 2D. PMV 2001 (Purple) .. 2E. PMV 2020 (Clear) .. 2F. PMV Secure-It .. 3G. PMV O2 Adapter (PMA 2000) .. 3H. PMV Patient Care Kit .. muir s (Positive Closure) Closed Position No Leak Design .. Between Closed Position No Leak PMVs andOpen Position valves .. Benefits of the (Positive Closure) Closed Position No Leak Passy-Muir valves .. 6A. Restores Positive Airway Pressure .. 6B. Improves Voice/Speech Production .. 6C. Improves Swallow/May Reduce Aspiration .. 6D. Facilitates Secretion Management.

2 7E. Improves Oxygenation .. 7F. In-Line Ventilator Use and Interchangeability .. 7G. Expedites Weaning .. 7H. Reduces Decannulation Time .. 8I. Improves Olfaction .. 8J. Facilitates Infection Control .. 8K. Pediatric Speech/Language Development .. 8L. Quality of Life .. for Use of the Passy-Muir Speaking Valve .. for Use of the Passy-Muir Speaking Valve .. 9A. Inflated Tracheostomy Tube Cuff .. 9B. Unconscious and/or Comatose patients .. 9C. Severe Medical Instability .. 9D. Foam-Filled Cuffed Tracheostomy Tube .. 10E. Severe Airway Obstruction .. 10F. Unmanageable Secretions .. 10G. Severe Risk for Aspiration .. 10H. Severely Reduced Lung Elasticity .. 10I. Other artificial airways.. 10J. Sleep .. Assessment (Guidelines) .. 10A. Team Approach .. 10B. Patient Assessment .. Placement of the PMV (Non- Ventilator Application).

3 13A. Patient and Staff Education .. 13B. Patient Bedside Assessment .. 13C. Positioning .. 13D. Suctioning .. 14E. Cuff Deflation .. 14F. PMV Attachment .. 14G. Connections .. 15H. Troubleshooting and Transitioning Issues .. 17I. Removing The PMV .. Application .. 19A. Patient Assessment/PMV Placement Section Review .. 19B. Ventilator Assessment .. 20C. Ventilator Adjustments .. 20D. PMV Connections .. 22E. Troubleshooting and Transitioning .. 24F. Monitoring Devices .. 27G. Removing the PMV .. and Decannulation .. 27A. Ventilator Weaning .. 27B. Decannulation .. Application ..29A. Reaction time .. 29B. Airway Obstruction .. 30C. Psychological Aspects .. 30D. Power of Communication .. 31E. Behavioral Considerations .. Issues .. 31A. Importance of Communication .. 31B. Legal Mandates .. and Lifetime of the Passy-Muir Tracheostomy and VentilatorSpeaking valves and Accessories.

4 35A. Cleaning Procedure .. 35B. Lifetime of the PMV .. 35 XVI. Cost Effectiveness & Reimbursement .. 35 XVII. Program Development .. 36A. Tracheostomy Team .. 36B. Marketing of the PMV .. 36 XVIII. Manufacturers Resource List .. 37 XIX. Bibliography .. Forms .. 51 Passy-Muir RESOURCE GUIDETHE Passy-Muir Tracheostomy ANDVENTILATOR Speaking valves , David MuirThe Passy-Muir Tracheostomy and Ventilator Speaking valves (PMVs) are the innovativeinvention of David muir , who as a result of muscular dystrophy, was quadriplegic. In 1985he required a Tracheostomy and became Ventilator dependent, which rendered him unable tocommunicate. He tried to utilize the communication products available at the time fortracheostomized individuals, however none of them worked to his satisfaction. With hisown idea of how a one-way Speaking valve should work and his father s assistance, Daviddeveloped the PMVs which enabled him to speak normally both on and off the valves are indicated for in-line Ventilator use and have a unique, patented closedposition no leak design.

5 For nearly six years this ingenious individual had the satisfactionof seeing both children and adults benefit from his invention. Unfortunately, David passedaway in August, 1990, at the age of twenty-eight. David s legacy, the PMV, has returnedindependence and dignity to thousands of tracheostomized and Ventilator dependentindividuals all over the of the Passy-Muir valves (PMVs)The Passy-Muir Tracheostomy and Ventilator Speaking valves (PMVs) are small, lightweight,and designed to fit the universal 15mm hub of Tracheostomy tubes. The design of the PMVincorporates a larger diameter pathway so inspired air is not restricted as may occur withother one-way Speaking valves . All PMVs can be used interchangeably by tracheostomizedand Ventilator dependent patients with the exception of the PMV 2020 TracheostomySpeaking Valve for use with metal Tracheostomy tubes which is not indicated for ventilatoruse.

6 They are easily adapted for use in-line with a Ventilator circuit and can be used inconjunction with closed suctioning systems, swivel adapters, supplemental oxygen,humidification, etc. All Passy-Muir Speaking valves have the patented, closed position noleak Valve Products and AccessoriesA. PMV 005 (White) Tracheostomy and Ventilator Speaking Valve15mm PMV 005 is the original PMV. While it is more commonlyused by non- Ventilator dependent, tracheostomized personsand placed directly on the 15mm hub of the tracheostomytube, it can also be used in-line with a Ventilator using non-disposable, flexible, rubber 005 (White)1 October 1997, Revised March, 2003 Passy-Muir , RESOURCE 007 (Aqua) Tracheostomy and Ventilator Speaking Valve15mm PMV 007 is designed to fit inside adult 22mm Ventilator tubing.

7 Use of an adapter may be neededto connect the PMV to pediatric Ventilator tubing or variousclosed suctioning systems. It fits directly on the 15mm hubof the Tracheostomy tube or can be used with various adapters( swivel, Omniflex ). The bright color makes it easier tosee while in the Ventilator tubing. The PMV 007 can also beused off the PMV 2000 (Clear) Low Profile - Lower ResistanceTracheostomy and Ventilator Speaking Valve15mm PMV 2000 is lightweight, smaller in size than the PMV005 and PMV 007 and opens easier during inhalation. ThePMV 2000 can be used directly on the 15mm hub of atracheostomy tube as well as in-line with the Ventilator usingnon-disposable, flexible, rubber tubing. The PMV 2000 is clearin color to make it less visible for use by the more ambulatorypatient. The PMV 2000 is designed to be used with the PMVS ecure-It , a device that allows the PMV to remain connectedto the Tracheostomy tube tie to prevent PMV PMV 2001 (Purple) Low Profile - Lower ResistanceTracheostomy and Ventilator Speaking Valve15mm PMV 2001 is identical to the PMV 2000 (Clear) except for itscolor.

8 This bright purple color makes it easier for staff/caregiversto identify the PMV while being worn as well as easier to locate ifit becomes misplaced ( in the bed sheets). It is also designedto be used with the PMV Secure-It and can be used on or off theventilator utilizing non-disposable, flexible, rubber PMV 2020 (Clear) Low Profile-Lower ResistanceTracheostomy Speaking Valve and PMA 2020-S Adapter forUse on Metal Tracheostomy Tubes15mm PMV 2020 attaches to the Pilling Weck metal JacksonImproved Tracheostomy tubes (sizes 4 - 6 or equivalent) withuse of the PMA 2020-S Adapter. It can also be used on theadult, pediatric and neonatal Bivona non-foam filled cuffedtracheostomy tubes currently on the market. The PMV 2020(Clear) is intended for use by both short-term and long-termadult, pediatric and neonatal non- Ventilator dependenttracheostomized patients .

9 The PMV 2020 and PMA 2020-Sare sold as a set. Replacement PMA 2020-S Adapters are alsosold in sets of three (3).PMV 2001 (Purple)PMV 2000 (Clear)PMV 2020 (Clear) withthe PMA 2020-S AdapterPMV 007 (Aqua)2 October 1997, Revised March, 2003 Passy-Muir , RESOURCE GUIDEPMV Secure-It attachedto the PMV 2000 (Clear)PMV O2 Adapter attachedto the PMV 2001 (Purple)PMV Patient Care KitE. PMV Secure-It - The PMV Secure-It is designed foruse with the Low Profile - Lower Resistance PMV 2000 SeriesValves [PMV 2000 (Clear), PMV 2001 (Purple) and PMV2020 (Clear)]. The PMV Secure-It is a device that attachesthe PMV to the trach tie to prevent valve loss. One PMVS ecure-It is packaged with each of the PMV 2000 SeriesValves. The PMV Secure-It is also sold separately from thePMV in sets of five (5).F. PMV O2 Adapter (PMA 2000) - The PMV O2 Adapter allowsfor easy inhalation of low flow, supplemental oxygen andhumidity through the Low Profile - Lower Resistance PMV2000 Series Tracheostomy and Ventilator Speaking PMV O2 Adapter is small, lightweight, clear in color andeasily snaps onto both the PMV 2000 (Clear) and PMV 2001(Purple) Tracheostomy and Ventilator Speaking is delivered in front of the intake side of the PMV toavoid complications associated with devices that providecontinuous flow behind the valve which may include airtrapping, drying of secretions and possible cilia PMV O2 Adapter allows the patient the opportunity tohave improved mobility and is easily removed when not inuse.

10 The PMV O2 Adapter is not for use with any valve otherthan the PMV 2000 (Clear) and PMV 2001 (Purple). The PMVO2 Adapter is sold PMV Patient Care Kit - Each PMV comes packaged in acolor coded PMV Patient Care Kit designed to facilitate properuse and maintenance of the PMV and to ensure patients havecomplete product information and instructions upon PMV Patient Care Kit contains the following items:1. Ziplock Pouch - a durable, ziplock pouch designed to hold all items in the PMV PatientCare Kit as well as provide extra room for any additional adapters and accessories that maybe PMV - each Kit contains one of the following valves : PMV 005 (White) Tracheostomyand Ventilator Speaking Valve, PMV 007 (Aqua) Tracheostomy and Ventilator SpeakingValve, PMV 2000 (Clear) Low Profile - Lower Resistance Tracheostomy and VentilatorSpeaking Valve PMV 2001 (Purple) Low Profile - Lower Resistance Tracheostomy andVentilator Speaking Valve or PMV 2020 (Clear) Tracheostomy Speaking Valve withPMA 2020 - S PMV Storage Container - a small plastic cup to allow for storage of a clean PMV whenit is not being October 1997, Revised March, 2003 Passy-Muir , RESOURCE GUIDE4.