|Artificial nose (or filter exchanger or heat and moisture exchanger)|
- A device that serves to humidify, warm and filter the air inhaled by capturing the end portion of exhaled air that was humidified and warmed by the lungs.
- Used in children whose condition permits.
- Filters the air inhaled of any particles that may irritate the lungs.
- Some artificial nose models connect to the tracheal cannula while others can be placed in the respirator circuit.
- Can be used at any time but mainly used during the day to facilitate outings particularly in cold temperatures and in areas where there is a lot of dust.
- Useful in protecting the tracheal cannula opening in certain situations (bathing or to protect against the aspiration of small objects).
- Certain models allow connection to oxygen.
- Not to be used with a heated humidifier or nebuliser as this may cause an over-accumulation of humidity which can cause breathing problems.
- An artificial nose is not recommended for nighttime use in children who are on a ventilator; instead an integrated heated humidifier is recommended.
- Must be discarded and replaced every day, or more often, when filled with secretions or water.
- A device that serves to humidify inhaled air.
- Connected to a large volume nebulizer and an air compressor.
- Used primarily during naps and at night.
- It can also be used to deliver medication or oxygen via a small volume nebulizer.
- Installed over the tracheal cannula and attached around the neck.
- Clean once a week (or more often if needed) with warm non-perfumed soapy water; rinse in warm tap water and let air dry completely before storing in a clean, closed container.
- Replace the tracheal collar every three months or more often if required according to the manufacturer’s recommendations or your child’s health care team.
|Air compressor for humidity delivery|
- A machine that allows for the delivery of humidity via a tracheal collar and aids in the prevention of mucus plugs.
- Requires the use of demineralized water in order to avoid harmful calcium deposits that may accumulate when boiled water is used.
- Since this equipment can limit your child’s movements, it is often used at night and during naps.
- The equipment must be well maintained in order to avoid the growth of bacteria or mold. Follow the manufacturer’s recommendations or that of your child’s health care team.
|Heated humidifier (or heated humidifier plate)|
- A device that is integrated into a ventilatory assistance device in order to deliver heated humidity.
- Generates a higher humidity level than an artificial nose, and so is usually recommended at night, during naps and as much as possible during the day.
- Can be used with a tracheal collar or a ventilatory interface.
|Speaking valves (ex: Passy-Muir®, Shiley®)|
- A device that attaches to the tracheal cannula connector and helps the child to speak, while allowing the continuous passage of air.
- Used in children whose condition permits.
- The one way valve opens during inspiration (air taken in through the tracheostomy) and closes during expiration (air expelled out through the tracheostomy); this causes the exhaled air to be directed past the vocal cords so that the child can speak.
- Increases the ability to swallow.
- Improves the capacity to taste and to smell odors.
- Remove the valve before providing all aerosol therapy treatments.
- If a cuffed tracheal cannula is in place, the cuff must always be deflated before using a speaking valve.
- Clean the valve every day with warm water and a mild non perfumed soap; rinse thoroughly with warm tap water and let air dry completely before storing in a clean, closed container.
- Change the valve if it becomes sticky, noisy, has black residue or if it vibrates even when cleaned regularly.
- Refer to the manufacturer’s recommendations for the duration of use. A well maintained speaking valve should last at least 2 months (Passy-Muir®) or 28 or 30 days (Shiley®).
|Small volume nebulizer (or mini nebulizer)|
- A device used to provide an aerosol treatment.
- The nebulizer, when connected to an air compressor, aerosolizes medication so that it can easily be inhaled and reach the lungs.
- The nebulizer is attached directly to the tracheal collar or a T piece added to the respiratory circuit that allows the child to inhale the medication.
|Metred dose inhaler (MDI) (or pump or puffer) with a spacer (Aerochamber® or air chamber)|
- Provides a metered dose inhaler treatment.
- A metered dose inhaler is a device that delivers medication in the form of an aerosol; it delivers very small particles of medication to the lungs.
- A metered dose inhaler is a metal cartridge inserted into a plastic casing; the medication is contained under pressure in the metal cartridge.
- When the cartridge is pushed downwards, a puff of aerosolized medication is released.
- The use of an in line air chamber, allows for the fine mist of particles (puff) to slow down and accumulate after the cartridge is pushed downwards, so that the aerosolized medication can then be inhaled in a more coordinated, controlled fashion at your child’s own pace.
- Treatment with a metered dose inhaler can be delivered via the tracheal cannula connector or via an in-line ventilator circuit metered dose inhaler adapter.