PMVs Under Pressure on a Tracoe Trach

Ainsley's Mom · #1 08-01-2008, 02:39 PM

Just wondering if anyone of your kids wear a Tracoe trach and you have had the PMV pop off from being under too much pressure?

I thought that it wouldn't because it's too tight (accessories fit just a hair tighter on a Tracoe) but I switched Ainsley to the Shiley last night and the PMV hasn't popped off that either. So perhaps she's just doing better. But it would be nice to know if it's possible for a PMV to pop of a Tracoe. Then I could switch her back with more peace of mind.

haltec · #2 08-01-2008, 03:12 PM

Hi Susan.

Sienna's could pop off the passy, but it didn't happen very often. Usually when she sneezed.
There was a big difference between the old tracoes and the new tracoes. When we would use the old ones, things popped off more frequently.
However, she was able to sneeze the PMV off with the new ones.

I hope that makes sense. I think it's possible, but more difficult.

debvec · #3 08-01-2008, 06:18 PM

I know with the Shileys which we used to use, it seems that they are not always the same diameter on the outside, we would have some that slipped off easy, some that were hard to get off etc. It may be the same with the Tracoe. When we had one that the valve would pop off of we would just change to a new trach and that would fix the problem.

Amanda's mom, deb.

Ainsley's Mom · #4 08-01-2008, 07:09 PM

Quote:

Originally Posted by debvec

I know with the Shileys which we used to use, it seems that they are not always the same diameter on the outside, we would have some that slipped off easy, some that were hard to get off etc. It may be the same with the Tracoe. When we had one that the valve would pop off of we would just change to a new trach and that would fix the problem.

Amanda's mom, deb.

I actually want it to be able to pop off as a precaution in case too much pressure builds up. In the past the PMV would pop off the Shiley. I think it still would. I think perhaps she's just doing better. I just want to know that someone has had the PMV pop off a Tracoe since they fit just a bit tighter before I have her wearing the PMV on a Tracoe for long periods of time.

debvec · #5 08-02-2008, 07:38 AM

OHHH I must have missed that, so sorry, could you maybe file the outside down a little with a nail file or something just to make it slip a bit? Just a thought, but if she is doing better then the point is moot.

Amanda's mom, deb.

Ainsley's Mom · #6 08-03-2008, 04:21 AM

I've confirmed it. The Tracoe's are indeed just a hair tighter than a Shiley (can't speak for other trachs we've only tried the two). What I've discovered is that while this is true there is also another difference. The Shiley connector (the part the PMV goes on) is slightly tapered so it is wider as it gets closer to the neck. If the PMV is positioned more loosely or toward the front of the connector it is easier to pop off. How do I know all this? A small experiment.

We took a Shiley and Tracoe trach and put the PMV on it and blew as hard as we could through the cannula to try to pop it off. My husband has stronger lungs than I do and even he could not get the PMV to pop off the Tracoe no matter how hard he blew. Now I've heard Tracoe is going to redesign their trachs to be a little less tight so perhaps this will not be an issue in the future. And if your child tolerates the PMV well it may not be an issue. He was able to get it to pop off the Shiley but it was difficult for him to do. More so if the PMV was on tightly. If you don't push it back as hard then it's easier to pop off.

Now that I've tried it for myself, and know how much effort it takes to pop a PMV off, I will not use that as an indicator that there is too much pressure. If Ainsley seems to be struggling at all I will take it off. It was very surprising how much effort it took. Actually my lungs kind of feel strained from trying.

Even so, just as a precaution, I think I will ask her otolaryngologist to write orders to switch her back to a Shiley. Now that she's able to tolerate the PMV better I would like to know that if she runs into trouble it can pop off if it has to.

KJKK8437 · #7 08-04-2008, 10:07 AM

Quote:

Originally Posted by Ainsley's Mom

I've confirmed it. The Tracoe's are indeed just a hair tighter than a Shiley (can't speak for other trachs we've only tried the two). What I've discovered is that while this is true there is also another difference. The Shiley connector (the part the PMV goes on) is slightly tapered so it is wider as it gets closer to the neck. If the PMV is positioned more loosely or toward the front of the connector it is easier to pop off. How do I know all this? A small experiment.

We took a Shiley and Tracoe trach and put the PMV on it and blew as hard as we could through the cannula to try to pop it off. My husband has stronger lungs than I do and even he could not get the PMV to pop off the Tracoe no matter how hard he blew. Now I've heard Tracoe is going to redesign their trachs to be a little less tight so perhaps this will not be an issue in the future. And if your child tolerates the PMV well it may not be an issue. He was able to get it to pop off the Shiley but it was difficult for him to do. More so if the PMV was on tightly. If you don't push it back as hard then it's easier to pop off.

Now that I've tried it for myself, and know how much effort it takes to pop a PMV off, I will not use that as an indicator that there is too much pressure. If Ainsley seems to be struggling at all I will take it off. It was very surprising how much effort it took. Actually my lungs kind of feel strained from trying.

Even so, just as a precaution, I think I will ask her otolaryngologist to write orders to switch her back to a Shiley. Now that she's able to tolerate the PMV better I would like to know that if she runs into trouble it can pop off if it has to.

I'm sending you the Bivona flexstends. I think you may find them another potential solution to this issue. Either Alex has lots of blow power, or the PMV flies off the Bivonas with some ease. I'll admit, I've never tried to blow one off myself (you guys never cease to amaze me), but I am always running after the PMV to put it back on Alex. Having said that, we never actually tried the Flexstends (only the regulars). There is more "tube space" in the flex, so there may be differences in pressure tolerance.

Boys3 · #8 08-04-2008, 01:21 PM

I am sooo glad you wrote that. I thought I was nuts and doing something wrong. My son can blow his across the room he totally doesnt keep it on at all. It could actually be a good party trick!
Kate

Ainsley's Mom · #9 08-04-2008, 03:54 PM

Quote:

Originally Posted by KJKK8437

... but I am always running after the PMV to put it back on Alex.

We play the chase the PMV game too, or at least we did when Ainsley was wearing the Shiley. I had trialed her back on the Shiley 3.0 Neo on Thursday and she tolerated it okay but I just felt it's a bit small she sounds noisier because the tube is smaller. In Feb we had tried to use the Shiley 3.5 Ped but she wasn't able to tolerate them (causing coughing but she was sick then). Last night I decided to try them again and what do you know, she seems to not only be fine, but I almost think she's better able to get the secretions up because of the longer length. So today I asked the ENT to prescribe those again.

I'm thinking maybe we'll be good with these and we probably don't need the Bivonas after all, but thank you. I feel much better knowing that she's safe wearing the PMV because it can pop off the Shiley if needed. I might even have to start using that rubber tie that comes with the PMV to keep it from flying across the room. I don't know why I've never tried it.

KJKK8437 · #10 08-04-2008, 04:31 PM

Quote:

Originally Posted by Ainsley's Mom

I might even have to start using that rubber tie that comes with the PMV to keep it from flying across the room. I don't know why I've never tried it.

Hee, hee. Um. The trachs are in the mail. Feel free to repost them if you don't want them.

I tried the rubber tie ... funny ... sorta. Alex thinks anything on his body is for him to yank on. Fun, right? Well, not if he yanks on the little rubber string and starts moving his trach out of alignment. Yank-cough; yank-cough; yank-cough. Cause and effect at this age isn't always well-formed!