Passy-Muir PMV 005 Mode D'emploi page 10

1. Review the previous section marked "Passy-Muir Tracheostomy and
!
Ventilator Speaking Valve Placement: Non-Ventilator Dependent Application"
for the following information:
• Education
2. Ventilator Assessment: Assessment of ventilator settings before, during and after
PMV placement include but are not limited to the following:
• Mode
• Tidal Volume (V
• Rate
• Fraction of Inspired
Oxygen Content (FI0
Note: All ventilator adjustments require a physician's order.
3. Cuff Deflation: If the patient has a cuffed tracheostomy tube, ventilator adjustments
may be required to compensate for leakage around the tracheostomy tube after cuff
deflation in order to meet the patient's comfort and ventilatory requirements. The
patient with a cuffed tracheostomy tube should be evaluated for a cuffless tracheostomy
tube if medically appropriate to eliminate the need for cuff deflation with use of the
PMV.
If the PIP decreases significantly following cuff deflation, inspired air may be escaping
through the upper airway and not entering the lungs. To compensate, adjustments to
V may be necessary. Increase V
T
until PIP's match those previous to cuff deflation. (When adjusting V
V increases may result in an increase in PIP.)
T
WARNING: DO NOT EXCEED PRE-CUFF DEFLATION PEAK INSPIRATORY PRESSURES.
WARNING: TRACHEOSTOMY TUBE MUST BE COMPLETELY DEFLATED BEFORE
PLACING THE PMV. PATIENT WILL BE UNABLE TO BREATHE IF CUFF IS NOT
COMPLETELY DEFLATED . PMV CANNOT BE USED WITH FOAM FILLED CUFFED
TRACHEOSTOMY TUBES. THE PMV CAN BE USED WITH A CUFFED TRACHEOSTOMY
TUBE IF THE CUFF IS COMPLETELY DEFLATED AND THE PATIENT HAS SUFFICIENT
AIRFLOW AROUND THE TRACHEOSTOMY TUBE AND BULK OF THE DEFLATED
CUFF.
4. PMV Attachment: Apply connector side of the PMV directly to patient's tracheostomy
tube (Fig. 5) by stabilizing the tracheostomy tube with one hand and attaching the
PMV to the 15mm hub of the tracheostomy tube with the other hand using an
approximate 1/4 twist. The PMV has a friction fit to ensure secure placement. The
connector side of the PMV can also be attached via a swivel adapter (Fig. 6), Omniflex
or closed suction catheter. The PMV 007 (Aqua) can be used in-line with pediatric
ventilator circuitry by using adapters that provide for a 22mm O.D. connection.
WARNING: DO NOT ATTACH THE PMV SECURE-IT™ WHEN USING THE PMV 2000
(CLEAR) OR PMV 2001 (PURPLE) IN-LINE WITH THE VENTILATOR AS THIS MAY
INTERFERE WITH DISCONNECT ALARM.
CAUTION: Excessive force should not be used when placing the PMV 005 (White) on
the tracheostomy tube, swivel adapter or in-line suctioning system, as it may obstruct
movement of the PMV diaphragm.
CAUTION: The PMV should be attached as close to the tracheostomy tube as possible
and not further down in-line to prevent an increase in dead space and obstruction of
the PMV from water condensation in the ventilator tubing.
• Patient Assessment
• Positive End Expiratory Pressure (PEEP)
) • Peak Inspiratory Pressure (PIP)
T
• Sensitivity
• Alarm Settings
)
2
in small increments (to avoid overcompensation)
T
8
• Suctioning
for cuff deflation,
T
TM