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Passy-MuirInc.
Touching Lives
and
Advancing
Patient Care
Through
Education
Passy-Muir Tracheostomy and
Ventilator Speaking Valve
Resource Guide
Passy-MuirInc.
Passy-Muir Tracheostomy and Ventilator Speaking Valves T
ABLE

OF
C
ONTENTS
I.
Inventor, David Muir ....................................................................................................... 1
II.
Description of the Passy-Muir Valves (PMV) ................................................................. 1
III.
Passy-Muir Valve Products .............................................................................................. 1
A. PMV 005 (White) ...................................................................................................... 1
B. PMV 007 (Aqua) ....................................................................................................... 2
C. PMV 2000 (Clear) ..................................................................................................... 2
D. PMV 2001 (Purple) ................................................................................................... 2
E. PMV 2020 (Clear) ..................................................................................................... 2
F. PMV Secure-It ....................................................................................................... 3
G. PMV O
2
Adapter (PMA 2000) .................................................................................. 3
H. PMV Patient Care Kit ................................................................................................ 3
IV.
David Muirs (Positive Closure) Closed Position No Leak Design ............................. 4
V.
Differences Between Closed Position No Leak PMVs and
Open Position Valves ....................................................................................................... 5
VI.
Clinical Benefits of the (Positive Closure) Closed Position No Leak
Passy-Muir Valves ........................................................................................................... 6
A. Restores Positive Airway Pressure ............................................................................ 6
B. Improves Voice/Speech Production ........................................................................... 6
C. Improves Swallow/May Reduce Aspiration .............................................................. 6
D. Facilitates Secretion Management ............................................................................. 7
E. Improves Oxygenation............................................................................................... 7
F. In-Line Ventilator Use and Interchangeability .......................................................... 7
G. Expedites Weaning .................................................................................................... 7
H. Reduces Decannulation Time .................................................................................... 8
I.
Improves Olfaction .................................................................................................... 8
J. Facilitates Infection Control ...................................................................................... 8
K. Pediatric Speech/Language Development ................................................................. 8
L. Quality of Life ........................................................................................................... 8
VII.
Indications for Use of the Passy-Muir Speaking Valve ................................................... 9
VIII.
Contraindications for Use of the Passy-Muir Speaking Valve ........................................ 9
A. Inflated Tracheostomy Tube Cuff .............................................................................. 9
B. Unconscious and/or Comatose Patients ..................................................................... 9
C. Severe Medical Instability ......................................................................................... 9
D. Foam-Filled Cuffed Tracheostomy Tube ................................................................. 10
E. Severe Airway Obstruction ...................................................................................... 10
F. Unmanageable Secretions........................................................................................ 10
G. Severe Risk for Aspiration ....................................................................................... 10
H. Severely Reduced Lung Elasticity ........................................................................... 10
I.
Other artificial airways. ........................................................................................... 10
J. Sleep ........................................................................................................................ 10
IX.
Pre-Placement Assessment (Guidelines) ....................................................................... 10
A. Team Approach ........................................................................................................ 10
B. Patient Assessment .................................................................................................. 11 X.
Initial Placement of the PMV (Non-Ventilator Application) ......................................... 13
A. Patient and Staff Education ..................................................................................... 13
B. Patient Bedside Assessment ..................................................................................... 13
C. Positioning ............................................................................................................... 13
D. Suctioning ................................................................................................................ 14
E. Cuff Deflation .......................................................................................................... 14
F. PMV Attachment ..................................................................................................... 14
G. Connections ............................................................................................................. 15
H. Troubleshooting and Transitioning Issues ............................................................... 17
I.
Removing The PMV ................................................................................................ 18
XI.
Ventilator Application .................................................................................................... 19
A. Patient Assessment/PMV Placement Section Review ............................................. 19
B. Ventilator Assessment .............................................................................................. 20
C. Ventilator Adjustments ............................................................................................ 20
D. PMV Connections ................................................................................................... 22
E. Troubleshooting and Transitioning .......................................................................... 24
F. Monitoring Devices ................................................................................................. 27
G. Removing the PMV ................................................................................................. 27
XII.
Weaning and Decannulation .......................................................................................... 27
A. Ventilator Weaning .................................................................................................. 27
B. Decannulation .......................................................................................................... 28
XIII.
Pediatric Application ..................................................................................................... 29
A. Reaction time ........................................................................................................... 29
B. Airway Obstruction ................................................................................................. 30
C. Psychological Aspects ............................................................................................. 30
D. Power of Communication ........................................................................................ 31
E. Behavioral Considerations ....................................................................................... 31
XIV.
Psychosocial Issues ....................................................................................................... 31
A. Importance of Communication ................................................................................ 31
B. Legal Mandates ........................................................................................................ 33
XV.
Care and Lifetime of the Passy-Muir Tracheostomy and Ventilator
Speaking Valves and Accessories .................................................................................. 35
A. Cleaning Procedure.................................................................................................. 35
B. Lifetime of the PMV ............................................................................................... 35
XVI.
Cost Effectiveness & Reimbursement ........................................................................... 35
XVII. Program Development ..................................................................