For patients with artificial airways …
The Vibralung® Acoustical Percussor is designed to couple the sound waves that it emits directly to the airway opening for maximum effectiveness. The easiest way to do that in a majority of patients is through the simple mouthpiece that is included with the Patient Kit. However, some patients, particularly those with chronic neuromuscular or neuroparalytic conditions may have an artificial airway, such as a tracheostomy tube (“trach”). Others may have a temporary tracheal airway or endotracheal tube (“ETT”). In either case, the Vibralung Trach Interface Kit may be used to connect the Vibralung, with or without a concomitant aerosol delivery system, directly to the 15-mm OD airway connector on the trach tube or ETT.
The Westmed Circulaire® II aerosol delivery device may be coupled with the Vibralung Acoustical Percussor if wetting agents, hypertonic saline or other inhalation medications are prescribed. The Circulaire II is the only nebulizer system cleared by the FDA to attach to, and work in conjunction with, the electro-mechanical-acoustic Vibralung Acoustical Percussor. The Vibralung Trach Interface Kit, operated with or without the Circulaire II aerosol delivery system, is specifically designed to enable easy access to the trach tube and not interfere with its basic function while minimizing mechanical deadspace (rebreathed volume) to only 16 mL and allowing for designated inspiratory and expiratory pathways and the application of Positive Expiratory Pressure, if desired.
Unique Trach Interface.
The fundamental trach interface adapter (shown on the left) consists of a small 3-inch long plastic connector with a 15-mm ID opening on one end that is designed to fit the 15-mm OD connector on trach tubes and ETTs. The opposite end of the interface adapter is 22-mm OD to fit a 6-inch section of expandable corrugated tubing to complete the hookup with the Vibralung Hand-held Transducer (HHT). An inspiratory one-way valve (purple) allows inhalation of room air while a ¼-inch nipple, sealed with a tethered cap (blue) while not in use, allows up to 4 L/min of supplemental oxygen to be administered. Opposite the inspiratory valve is a Variable Expiratory Resistor that can adjust applied PEP from 0 to approximately 5 cmH2O. This assembly is single-patient use disposable.
Setup and Configuration.
The P/N 9646 Trach Interface Kit is able to be configured in two ways: (1) no concomitant aerosol delivery or (2) concomitant aerosol delivery. A P/N 0336 Circulaire II High-Efficiency Aerosol Drug Delivery System is included with each Trach Interface Kit and may be used optionally if aerosol drug delivery is desired.
Configuration Without Aerosol
To interface the Vibralung HHT and Circulaire II directly to a tracheal tube:
- Remove any mouthpieces from Vibralung and/or Circulaire II and set aside.
- Assemble the parts as shown in the illustration above. Use the HHT Hanger assembly (inset picture), supplied separately, to attach the complete assembly to a ventilator arm or similar device for support.
- Set PEP Resistor on the Circulaire II to its smallest opening.
- Set PEP Resistor on Trach Adapter to its largest opening.
- Connect to patient and operate nebulizer on Circulaire II aerosol device at 8 L/min. Consult Circulaire II Instructions for Use for further information on its operation.
- Adjust (close) PEP Resistor on Trach Adapter to comfortable level for patient.
- Turn on and set Vibralung Acoustical Percussor TCU for prescribed therapy mode. Consult Vibralung Acoustical Percussor Instructions for Use for further information on its operation.
Cautions and Warnings.
To avoid ineffective therapy or patient injury:
- Do not leave patient during Vibralung treatment with trach interface.
- Consider the need for an inflated or deflated trach tube cuff. The Vibralung should be able to flood the tracheobronchial tract with sound waves with a deflated cuff. However, if the Circulaire II aerosol delivery system is being employed simultaneously, the cuff will have to be inflated to allow the patient to effectively inhale through the Circulaire device.
- Be prepared to assist patient with secretion removal, including tracheal suctioning as needed.
- Observe trach tube for movement, stress, torque, pulling or pushing on trach tube that could result in accidental decannulation.
- Check on patient periodically for up to 90 minutes after treatment for need to suction trachea.
Using the HHT Hanger.
When used with the Trach Interface instead of a mouthpiece, having the patient hold the Vibralung’s Hand-held Transducer (HHT) by hand, may be less than optimal. Therefore an optional #9641 HHT Hanger assembly is available that allows supporting the HHT on the end of a typical ventilator support arm with a ¾-inch ball socket. The HHT Hanger snaps on to the HHT and includes a ¾-inch ball mount to attach to the ventilator arm.
Additional Mounting Options.
[download_link link=”http://test1.revolutionthree.net/wp-content/uploads/2016/12/VL-Mounting-Options-Sources.pdf” variation=”deepblue”]Download this “Mounting Options & Sources” flyer as a PDF file.[/download_link]
Vibralung Online Manuals
Information in the online manuals is always current and may supercede printed documents.
Click on a thumbnail image to download the specific manual(s) you desire in PDF format.
Circulaire II Hybrid Instructions for Use
Click the Circulaire II Hybrid thumbnail image below to download the Instructions for Use in PDF format.
For further information on the Circulaire II family of aerosol delivery systems, please visit the Circulaire II High-Efficiency Aerosol Drug Delivery Systems page.
[button link=”http://test1.revolutionthree.net/main/” size=”small” variation=”blue” textcolor=”#FFFFFF” align=”center”]Westmed Home[/button]