Airway Management Endotracheal Tubes

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Endotracheal Tubes

Introducing Unomedical Unomedical as a leading manufacturer and supplier of singleuse medical devices offers a broad range of high quality Airway-Management devices, designed to provide advanced solutions accommodating the requirements of medical professionals worldwide. All Unomedical products are processed by high quality materials with the maximum possible accuracy enabling Unomedical to meet the exceptional levels of safety, functionality and reliability that have become a Unomedical hallmark for more than 30 years. Unomedical groups its range of Airway Management solutions into three categories: Airways Artificial airways for anaesthesia, emergency and intensive care ventilation Intubation Devices for the introduction and intubation of artificial airways Airways Clearance Clearance Tracheobronchial suctioning devices for airway maintenance and clearance Intubation Endotracheal Tubes Unomedical offers a wide range of state-of-the-art Endotracheal Tubes with unique benefits for increased patient safety. Such as the Unomedical Colour Coding System which clearly indicates the correct suction catheter calibre to be used together with the chosen Endotracheal Tube, helping to avoid potential high levels of PEEP and/or high subatmospheric pressure levels in the lower airways.

Endotracheal Tubes Safety Functionality Reliability UnoFlex - Reinforced Endotracheal Tubes Unomedical Colour Coding System... 4 Standard Endotracheal Tubes... 6 Adult Endotracheal Tubes... 6 Pediatric Endotracheal Tubes... 7 Tube-Fix... 7 Naso-Fix... 7 Intensive Care Endotracheal Tubes... 8 Extended Volume Low Pressure (EVLP)... 8 EXTRA SOFT Pediatric Endotracheal Tubes... 8 Preformed Endotracheal Tubes... 9 Oral Preformed Endotracheal Tubes... 9 Nasal Preformed Endotracheal Tubes... 9 Oxford Endotracheal Tubes... 9 Preformed Endotracheal Tubes Reinforced Endotracheal Tubes... 10 UnoFlex... 10 Accessories... 11 Unomedical Intubation Stylets... 11 Guedel Airways... 11 MiniSpacer In-Line MDI... 11 Intensive Care Endotracheal Tubes The Complete Range... 12 Accessories Standard Endotracheal Tubes

Unomedical Colour Coding System Risks of tracheobronchial suctioning Suction procedures can cause impairment in gas exchange and lung mechanics including serious effects such as alveolar collapse, hypoxemia and desaturation. Amongst other factors, such as ventilation mode and suction force used, the size of the suction catheter chosen can significantly influence the incidence of such effects. Minimising the risk In order to minimise such effects, the calibre of the suction catheter should be choosen in relation to the inner diameter of the endotracheal/tracheostomy tube. The diameter of the suction catheter should be close to half the inner diameter of the airway used in order to provide sufficient room for ambient air to flow in. Since endotracheal tubes are identified by inner diameter (I.D.) and suction catheters by their Charrière (CH) or French (F) size, indicated by their colour coding, making the right choice is not always easy. The Unomedical Colour Coding System Always the right choice 1 Unomedical s Colour Coding System clearly indicates the appropriate suction catheter size, eases the choice for the medical professional and increases overall safety during suction procedures. All Unomedical Airways are equipped with a colour coded 15 mm connector reflecting the standardised** colour code of the recommended suction catheter. 2 3 References: Stenqvist O, Lindgren S, Karason S, Sondergaard S, Lundin S. Warning! Suctioning. A lung model evaluation of closed suctioning systems. Acta anaesthesiologica Scandinavica VOL:45(2); p.167-72/2001 Almgren B, Wickerts CJ, Heinonen E, Hogman M. Side effects of endotracheal suction in pressure- and volume controlled ventilation. Chest 2004;125:1077-80

Tube/Cannula Recommended Catheter size* Colour Code I.D. (mm) O.D. (mm) O.D. (CH) 3.0-3.5 1.3 4 4.0-4.5 2.0 6 5.0-6.0 2.7 8 6.5-7.0 3.3 10 7.5-8.0 4.0 12 8.5-9.0 4.7 14 9.5-11.0 5.3 16 Suction Catheters** Unomedical Tubes/Cannulas * In some cases catheter sizes slightly larger than 1/2 the diameter of the tube have been choosen to provide more effective removal of secretions. ** According to EN 1733 CH 06 CH 10 CH 14 CH 08 CH 12 CH 16 Airway/Lung model illustrating the reason for adverse effects when using a too large suction catheter calibre. During suctioning, the suction catheter (1) creates a negative suction force, causing sub atmospheric pressure in the lower airways/lung (3). Portion of inflowing air through the Endotracheal tube/ upper airways (2) is too poor to compensate since the suction catheter is blocking most of the lumen, inducing potential alveolar collapse. In case a suction catheter with an appropriate size has been chosen, enough room for ambient air to flow in and to minimise the effect of negative pressure is provided. Almgren, B; Endotracheal Suction a Reopened Problem. Acta Universitatis Upsaliensis. Digital Comprehensive Summaries of Uppsalla Dissertations from the Faculty of Medicine 11.55pp. Uppsala; 2005 AARC Clinical Practice Guideline. Endotracheal Suctioning of Mechanically Ventilated Adults and Children with Artificial Airways. Respir Care 1993;38:500-504

Standard Endotracheal Tubes Adult Endotracheal Tubes Colour Coding System Colour coded 15 mm connector for easy and quick identification of the correct suction catheter size (see also page 4-5 f.) Atraumaticity Gently rounded, drawn in bull nose tip ensures atraumatic and smooth intubation and facilitates fiberoptic intubation Easy Identification and Traceability Pilot ballon with tube size in mm ID and control number fills responding to the cuff and clearly indicates fill status Improved Position Control Grading in 1 cm steps provides reliable control of the tube position Effective Seal Thin walled and barrel shaped High Volume Low Pressure (HVLP) cuff for gentle and effective sealing Accurate Positioning Double ring marking helps to guide intubation by laryngoscopy ensuring accurate placement Perfect Adaption Radiopaque X-ray line Facilitates verification of tube positioning visible to the tip Soft, thermosensitive and kink resistant material ensures optimal anatomical adaption Optional Murphy Eye Smoothly formed to avoid vocal cord damage during intubation Gentle Intubation A soft transition between cuff and shaft without sharp edges provides atraumatic and smooth in- and extubation Available configurations HVLP Plain (uncuffed) Murphy Tip Magill Tip

Standard Endotracheal Tubes Pediatric Endotracheal Tubes Optional Murphy Eye Smoothly formed to avoid vocal cord damage during intubation and to prevent obstruction Atraumaticity Gently rounded, drawn in tip for atraumatic and smooth intubation Thin Walled Superior relationship of inner and outer diameter Accurate Depth Positioning A grading in 1 cm steps and a black line at the tip of the tube provide support for accurate positioning and repositioning Perfect Adaption Soft, thermosensitive and kink resistant material ensures optimal anatomical adaption Colour Coding System Colour coded 15 mm connector for easy and quick identification of the correct suction catheter size (see also page 4-5 f.) Available configurations HVLP Plain (uncuffed) Murphy Tip Magill Tip Tube-Fix Securement device for endotracheal tubes Designed to secure the position of orally intubated endotracheal tubes Minimum risk of pressure point creation Easy access to oral cavity and throat Two versions for securement with or without additional Guedel Airway Naso-Fix Securement tape for nasal tubes & catheters Secure fixation of nasal tubes Prevents displacement/saves time on re-introduction Optimum patient comfort Skin friendly fixation at optimum angle Discrete appearance Skin coloured/available in 3 different sizes Easy application and removal Efficient securement with minimum time consumption Please ask us for detailed information on our complete securement device programme

Intensive Care Endotracheal Tubes Extended Volume Low Pressure (EVLP) Endotracheal Tube Unomedical ELVP Endotracheal Tubes feature a special cuff of 1½ times the average trachea size, maintaining an improved low-pressure sealing during tracheal expansion and contraction. The increased length of the cuff reduces mucosal irritation by pressure distribution against a wider area of the tracheal tissue and provides improved protection against micro aspiration of fluid along the cuff. The cuff of the tube provides vertical elasticity against the tube shaft in order to buffer short-term intratracheal pressure (e.g. coughing) keeping the tube in correct position. EVLP Endotracheal Tubes include all features of Unomedical Standard Endotracheal Tubes including: Colour Coding System Gently rounded and drawn in bull nose tip Soft thermosensitive and kink resistant material Soft transition between cuff and shaft without sharp edges Responsive pilot ballon with tube size and control number print Available configurations Murphy Tip Magill Tip EXTRA-SOFT Pediatric Endotracheal Tube Pediatric Endotracheal Tube made from extremely soft special compound material for improved adaption to the airway anatomy, created for medium and long term ventilation in neonatal and pediatric Intensive Care. Soft material for improved adaption to the respiratory anatomy Transparent tube allows identification of condensation Superior relationship of inner and outer diameter EXTRA-SOFT Tubes include all features of Unomedical Standard Pediatric Endotracheal Tubes including: Colour Coding System Gently rounded and drawn in tip Grading in 1 cm steps and black line at tube tip for easy (re-) positioning

Preformed Endotracheal Tubes Oral Preformed/Nasal Preformed Unomedical Preformed Endotracheal Tubes are designed to direct the anaesthesia circuit away from the operative field - either in cranial or in caudal direction. Unomedical Preformed Endotracheal Tubes are available in a variety of configurations including pediatric and adult versions. Colour Coding System Easy and quick suction catheter identification Bull nose tip Gently rounded drawn in tip for maximum atraumaticity during intubation Soft thermosensitive material For optimal anatomical adaption Soft transition between cuff and shaft Transition without sharp edges provides atraumatic in- an extubation Double ring markings Accurate laryngoscopic tube positioning Responsive pilot ballon Clearly indicates fill status and provides important information Available configurations HVLP Plain (uncuffed) Murphy Tip Oxford Endotracheal Tubes Unomedical Oxford Endotracheal Tubes are preformed according to the two axes of the human airway anatomy. The have been designed for quick oral introduction, especially during emergency situations. 90 preformed shaft minimises the risk of kinking and dislocation in the oropharynx The rounded and drawn in tip is adjusted to the backside of the tube minimising the risk of hangups during glottic passage Unomedical Oxford Endotracheal Tubes feature a true High Volume Low Pressure (HVLP) cuff for prolonged ventilation without the need to exchange the tube. The proximal (horizontal) shank of the tube is prolonged in order to provide more room for efficient securement.

10 UnoFlex Reinforced Endotracheal Tubes The advanced Reinforced Endotracheal Tube Through innovation, UnoFlex is specially designed using a flat spiral wire embedded in the wall of the tube. This construction allows thicker protective layers around the wire minimising the risk of obstruction even under hardest conditions, while providing an excellent relationship of inner and outer diameter. UnoFlex features an additional X-ray line until the tip providing reliable inspection of tube positioning by chest radiography. Unomedical s spiral wire Conventional spiral wire Increased strength Easy Identification and Traceability Pilot ballon with tube size in mm ID and control number fills responding to the cuff and clearly indicates fill status Increased Safety Radiopaque line up to the tip Effective Seal Thin walled and barrel shaped High Volume Low Pressure (HVLP) cuff for gentle and effective sealing Colour Coding System Colour coded 15 mm connector for easy and quick identification of the correct suction catheter size (see also page 4-5 f.) Atraumaticity Gently rounded, drawn in bull nose tip ensures atraumatic and smooth intubation and facilitates fiberoptic intubation Accurate Positioning Double ring marking helps to guide intubation by laryngoscopy ensuring accurate placement Available configurations HVLP Optimal Adaption Extremely flexible and soft material for optimal anatomical adaption Plain (uncuffed) Murphy Tip Magill Tip

11 Accessories Unomedical Intubation Stylets Facilitates quick intubation of endotracheal tubes Low friction between stylet and the tracheal tube for easy insertion and withdrawal Smooth molded distal tip end Soft, slippery sheath extends past distal metal end to form atraumatic tip to reduce trauma during intubation Size 14 Size 10 Size 8 Guedel Airways Designed to maintain a secure Oropharyngeal airway for the unconscious patient in the Pre- Hospital Care and Hospital environment, under general anesthesia or during recovery. All sizes are colour coded for easy accessibility. Rounded atraumatic edges Smooth airway path for easy airway suctioning Bite block to prevent biting of tongue or Endotracheal tube Colour coded for easy identification of sizes Single packed/sterile MiniSpacer In-line MDI Metered Dose Inhaler adapter for in-line application of therapeutic aerosols during Anaesthesia Intensive Care ventilation Manual pulmonary resuscitation The MiniSpacer features a bi-directional aerosol plume, improving delivery of the MDI medication. 15 mm O.D. x 15 mm I.D. adaptor for placement directly to the Endotracheal Tube or to a closed suction system.

The Complete Range 12 Standard Endotracheal Tubes REF Magill, HVLP Cuff With Murphy Eye REF I.D. (mm) Size O.D. (mm) Length* (mm) MM6 1120 030 MM6 1110 030 3.0 4.1 185 MM6 1120 035 MM6 1110 035 3.5 4.8 185 MM6 1120 040 MM6 1110 040 4.0 5.4 205 MM6 1120 045 MM6 1110 045 4.5 6.1 225 MM6 1120 050 MM6 1110 050 5.0 6.7 245 MM6 1120 055 MM6 1110 055 5.5 7.3 275 MM6 1120 060 MM6 1110 060 6.0 8.0 285 MM6 1120 065 MM6 1110 065 6.5 8.7 295 MM6 1120 070 MM6 1110 070 7.0 9.3 305 MM6 1120 075 MM6 1110 075 7.5 10.0 315 MM6 1120 080 MM6 1110 080 8.0 10.7 325 MM6 1120 085 MM6 1110 085 8.5 11.3 325 MM6 1120 090 MM6 1110 090 9.0 12.0 325 MM6 1120 095 MM6 1110 095 9.5 12.7 325 MM6 1120 100 MM6 1110 100 10.0 13.3 325 Magill, Plain (without cuff) MM6 1140 020 MM6 1130 020 2.0 2.9 150 MM6 1140 025 MM6 1130 025 2.5 3.4 175 MM6 1140 030 MM6 1130 030 3.0 4.1 185 MM6 1140 035 MM6 1130 035 3.5 4.8 185 MM6 1140 040 MM6 1130 040 4.0 5.4 205 MM6 1140 045 MM6 1130 045 4.5 6.1 225 MM6 1140 050 MM6 1130 050 5.0 6.7 245 MM6 1140 055 MM6 1130 055 5.5 7.3 275 MM6 1140 060 MM6 1130 060 6.0 8.0 285 MM6 1140 065 MM6 1130 065 6.5 8.7 295 Intensive Care Endotracheal Tubes Magill, EVLP Cuff MM6 1420 060 MM6 1410 060 6.0 8.0 285 MM6 1420 065 MM6 1410 065 6.5 8.7 295 MM6 1420 070 MM6 1410 070 7.0 9.3 305 MM6 1420 075 MM6 1410 075 7.5 10.0 315 MM6 1420 080 MM6 1410 080 8.0 10.7 325 MM6 1420 085 MM6 1410 085 8.5 11.3 325 MM6 1420 090 MM6 1410 090 9.0 12.0 325 Magill Plain (without cuff), EXTRA-SOFT MM6 3140 020 MM6 3130 020 2.0 2.9 150 MM6 3140 025 MM6 3130 025 2.5 3.4 175 MM6 3140 030 MM6 3130 030 3.0 4.1 185 MM6 3140 035 MM6 3130 035 3.5 4.8 185 MM6 3140 040 MM6 3130 040 4.0 5.4 205 MM6 3140 045 MM6 3130 045 4.5 6.1 225 * Length w/o connector

13 The Complete Range Preformed Endotracheal Tubes REF With Murphy Eye REF I.D. (mm) Size O.D. (mm) Length* (mm) * Oral preformed, HVLP Cuff MM6 1213 040 4.0 5.4 130 MM6 1213 045 4.5 6.1 150 MM6 1213 050 5.0 6.7 155 MM6 1213 055 5.5 7.3 165 MM6 1213 060 6.0 8.0 180 MM6 1213 065 6.5 8.7 190 MM6 1213 070 7.0 9.3 200 MM6 1213 075 7.5 10.0 210 MM6 1213 080 8.0 10.7 220 MM6 1213 085 8.5 11.3 230 Oral preformed, Plain (without Cuff) MM6 1233 030 3.0 4.1 105 MM6 1233 035 3.5 4.8 120 MM6 1233 040 4.0 5.4 130 MM6 1233 045 4.5 6.1 150 MM6 1233 050 5.0 6.7 155 MM6 1233 055 5.5 7.3 165 MM6 1233 060 6.0 8.0 180 MM6 1233 065 6.5 8.7 190 * Nasal preformed, HVLP Cuff MM6 1313 060 6.0 8.0 295 MM6 1313 065 6.5 8.7 305 MM6 1313 070 7.0 9.3 313 MM6 1313 075 7.5 10.0 328 MM6 1313 080 8.0 10.7 335 Nasal preformed, Plain (without Cuff) MM6 1333 030 3.0 4.1 131 MM6 1333 035 3.5 4.8 160 MM6 1333 040 4.0 5.4 175 MM6 1333 045 4.5 6.1 202 MM6 1333 050 5.0 6.7 212 MM6 1333 055 5.5 7.3 215 MM6 1333 060 6.0 8.0 227 MM6 1333 065 6.5 8.7 234 Oxford Tubes MM6 1222 060 6.0 8.0** MM6 1222 070 7.0 9.3** MM6 1222 080 8.0 10.7** MM6 1222 090 9.0 12.0** * Length according to Illustration ** Length w/o connector

The Complete Range 14 REF Reinforced Endotracheal Tubes With Murphy Eye REF I.D. (mm) Size O.D. (mm) Length* (mm) Magill, HVLP Cuff MM6 1224 050 MM6 1214 050 5.0 7.2 270 MM6 1224 055 MM6 1214 055 5.5 7.7 270 MM6 1224 060 MM6 1214 060 6.0 8.4 295.5 MM6 1224 065 MM6 1214 065 6.5 8.9 315 MM6 1224 070 MM6 1214 070 7.0 9.7 325 MM6 1224 075 MM6 1214 075 7.5 10.3 335 MM6 1224 080 MM6 1214 080 8.0 10.8 340 MM6 1224 085 MM6 1214 085 8.5 11.1 340 MM6 1224 090 MM6 1214 090 9.0 11.9 340 Magill, HVLP Cuff - Preloaded with Intubation Stylet MM6 1224 150 5.0 7.2 270 MM6 1224 155 5.5 7.7 270 MM6 1224 160 6.0 8.4 295.5 MM6 1224 165 6.5 8.9 315 MM6 1224 170 7.0 9.7 325 MM6 1224 175 7.5 10.3 335 MM6 1224 180 8.0 10.8 340 MM6 1224 185 8.5 11.1 340 MM6 1224 190 9.0 11.9 340 Magill, Plain (without cuff) MM6 1144 025 MM6 1134 025 2.5 3.9 185 MM6 1144 030 MM6 1134 030 3.0 4.3 190 MM6 1144 035 MM6 1134 035 3.5 4.6 210 MM6 1144 040 MM6 1134 040 4.0 5.6 225 MM6 1144 045 MM6 1134 045 4.5 6.3 255 MM6 1144 050 MM6 1134 050 5.0 7.2 270 MM6 1144 055 MM6 1134 055 5.5 7.7 270 MM6 1144 060 MM6 1134 060 6.0 8.4 295.5 MM6 1144 065 MM6 1134 065 6.5 8.9 315 Magill, Plain (without cuff) - Preloaded with Intubation Stylet MM6 1144 125 2.5 3.9 185 MM6 1144 130 3.0 4.3 190 MM6 1144 135 3.5 4.6 210 MM6 1144 140 4.0 5.6 225 MM6 1144 145 4.5 6.3 255 MM6 1144 150 5.0 7.2 270 MM6 1144 155 5.5 7.7 270 MM6 1144 160 6.0 8.4 295.5 MM6 1144 165 6.5 8.9 315 Accessories REF * Length w/o connector ** Total length I.D. (mm) Size O.D. (CH) Length** (mm)/ Colour Code Intubation Stylets MM6 4200 006 2.0 6 310 MM6 4200 010 3.3 10 391 MM6 4200 014 4.7 14 391 Guedel Airways, single-packed sterile 220 24 18 00 Blue 22 023 18 0 Black 22 019 18 1 White 22 020 18 2 Green 220 21 18 3 Orange 22 022 18 4 Red MiniSpacer InLine MDI 8626003 Single, clean packed InLine Metered Dose Inhaler Adapter Unomedical a/s Kongevejen 2 DK-3460 Birkeroed Denmark Kilhof Grafisk 10148-2006-08 GB All Unomedical products are CE-marked according to the Directive 93/42/EEC concerning medical devices. Phone: +45 48 16 70 00 Telefax: +45 48 16 70 45 www.unomedical.com