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Critical Care update April 2012 Thailand

Critical Care update April 2012 Thailand. Intersurgical nFlow Infant nasal CPAP system . Infant nasal CPAP. nFlow. Introduction. Product. Product function. Material. Promotion. Ordering codes. Instruction. Equipment compatibility. Competition . nFlow introduction.

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Critical Care update April 2012 Thailand

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  1. Critical Care update April 2012Thailand

  2. Intersurgical nFlowInfant nasal CPAP system.

  3. Infant nasal CPAP

  4. nFlow • Introduction. • Product. • Product function. • Material. • Promotion. • Ordering codes. • Instruction. • Equipment compatibility. • Competition.

  5. nFlow introduction • Infant CPAP with gas flip technology has been used for 25 years. • Original concept was from two Swedish doctors. • Designed to give as near natural breath as possible at the PEEP level. • Jetted flow to satisfy inspiratory PEEK flow,with minimum effort. • Gas flip when desired pressure level is achieved minimises expiratory work of breathing.

  6. nFlow introduction • Provides a clinically proven non invasive support for the pre-term infant. • Used as an alternative to conventional more invasive forms of respiratory support. • Infant CPAP with gas flip technology has changed neonatal respiratory support, fewer ventilators are sold per year now than when it was first launched. • Now has world wide recognition as an effective treatment for the neonate. • Infant flow has been patented for past 25 years patents expired this year.

  7. nFlow System • nFlow heated wire system. • 12 bonnets. • 3 nasal prongs. • 3 nasal masks. • Bonnet size guide. • Mask and prong size guide. Optional silencer kit • Instructions for use.

  8. nFlow codes • 4700000NFLOW INFANT NASAL CPAP SYSTEM HEATES WIRE12 per box • 4701000 NFLOW NASAL PRONG SMALL 30 per box • 4702000 NFLOW NASAL PRONG MEDIUM 30 per box • 4703000 NFLOW NASAL PRONG LARGE 30 per box • 4704000 NFLOW MASK PRONG SMALL 30 per box • 4705000 NFLOW MASK PRONG MEDIUM 30 per box • 4706000 NFLOW MASK PRONG LARGE 30 per box • 4707000 INFANT BONNET WHITE SIZE 000 (18-20cm) 20 per box • 4707100 INFANT BONNET GREY SIZE 00 (20–22cm) 20 per box • 4707110 INFANT BONNET PINK SIZE 0 (20–24 cm) 20 per box • 4707001 INFANT BONNET DARK GREYSIZE 1 (24–26cm) 20 per box • 4707002 INFANT BONNET YELLOW SIZE 2 (26-28 cm) 20 per box • 4707003 INFANT BONNET BLUE SIZE 3 (28–30cm) 20 per box • 4707004 INFANT BONNET LIGHT ORANGE SIZE 4 (30–32cm) 20 per box • 4707005 INFANT BONNET GREEN SIZE 5 (32–34cm) 20 per box • 4707006 INFANT BONNET RED SIZE 6 (34–36cm) 20 per box • 4707007 INFANT BONNET ORANGE SIZE 7 (36–38cm) 10 per box • 4707008 INFANT BONNET TURQUOISE SIZE 8 (38–40cm) 10 per box • 4707009 INFANT BONNET NAVY SIZE 9 (40–42cm) 10 per box • 4708000 NFLOW SILENCER KIT 25 per box

  9. nFlow function. • nFlow system pack, prongs, mask and bonnet boxes all include instructions for use. • System pack includes bonnet size guide and mask/prong size guide.

  10. nFlow function • Flow rate controls CPAP/PEEP level(e.g 8 lpm flow gives 5cmH2O pressure) • Internal chamber designed allows excess gas to run to exhaust tube. • Patient inspiratory peek flow satisfied via two jets. • Fresh gas flips between supply for inspiration to maintaining desired CPAP/PEEP level. • Patients expiratory gas is removed through exhaust tube. • There are NO moving parts in this generator.

  11. Gas flip technology (inspiration). Graph from MG when ready.

  12. Gas flip technology (expiration).

  13. Gas flip technology.

  14. nFlow function. • Exhaust tube is manufactured from Super Set style tube and has small slits to prevent overpressure if occluded. • Optional Silencer kit, can be added to end of exhaust tube if required. (4708000)

  15. Function issues for the end users. • All nFlow and Infant flow systems use a heated wire system with chamber. • Back pressure in the system is up to 140 cmH2O. • Reservoir bag will inflate at this pressure. • Options available are: • Manual fill from bag using clamp. • Manual fill into chamber. • Auto fill with pressure fuser bag. • Auto Fill with extension pole to lift bag higher.

  16. nFlow materials Bonnets cotton Flow Driver Monitor line connector ABS Monitor and pressure lines phthalate free PVC. Exhaust tube Poly Propylene Generator body ABS Prongs and mask silicone. Fixation straps Polyamiael and Polyether

  17. nFlow promotion • Target areas. • Neonatal intensive care. • Special Care Baby units. • Neonatal inter department or Inter hospital transport. • Cost effective option to Cardinal. • Less wastage prongs and masks supplied separately. • Less system connections • High quality product • Package with other products

  18. Promotional material • Information Sheet (IS 1.06)featuring strap line “designed to care”. • Website – dedicated landing page • Video – Showing correct fitting. • Function drawings. • Performance graphs. • Editorial. – Editorial will be available for all appropriate journals.

  19. Instruction for use.

  20. Equipment compatibility(Equipment found in the market that nFlow can be used with).

  21. EME INFANT FLOW DRIVER

  22. Viasys Infant Flow driver and SiPAP driver

  23. Hamilton Aladdin flow driver

  24. Hamilton Arabella flow driver

  25. Acutronic medical systems Fabian Neonatal ventilator can Be used to drive Infant Flow and nFlow.

  26. nFlow Competition(direct competitors in the infant nasal CPAP area). • Cardinal/ Care Fusion Infant Flow/ Air Life. • Hamilton Arabella. • Medin Medical Innovations. • Inspiration healthcare. • F&P Bubble humidifier.

  27. Care Fusion • EME – Viasys – Cardinal – Care Fusion • Designed by Swedish doctor first in the market with EME.

  28. Hamilton Arabella • Aladdin – Arabella. • OEM from EME. • Name changed after legal. dispute with EME. • Adult ventilator company not focused in this area. • Expensive. • Was sold in some markets as SLE 1100.

  29. Medin Medical inovations • Medin Medijet. • Does not include gas flip technology. • Requires dedicated driver. • Poor expiratory work of breathing.

  30. Inspiration Healthcare • Ex EME staff. • Small company. • Poor accessories. • Same design as Infant Flow.

  31. F&P Bubble CPAP

  32. nflow equipment Connection Exhaled and excess gas (1) Fresh gas supply humidified (2) To pressure monitor (3) 1/ The exhaled gas tube is a superset limb that is left open to atmosphere and moves the excess and exhaled gas away from the patient. A 2/ The fresh gas supply tube is connected to the driver, because the generator features to small jets (A), through which the fresh gas flows, a back pressure is generated in this line and is seen in the supply equipment, up to 140 cmH2O. 3/ The pressure monitor line connects to the supply equipment and allows the equipment to monitor air way pressure Up to 30 cmH2O

  33. nFlow equipment connection. Because of the back pressure generated in the fresh gas line, (please read explanation on previous slide), all machines or equipment that connects to the nFlow system must be able to deliver a fresh gas flow up to 20 lpm with a peak pressure of 140cmH2O. Most NICU ventilators are factory set to give a PEEK system Pressure of around 50 cmH2O so will not function with the nFlow or any Infant CPAP system with gas flip Technology. The only Neonatatal ventilator that will function with nFlow is the Acutronic Fabien which has been designed to include a high pressure delivery option.

  34. Pressure volume loop through a ventilator using a two limb system in CPAP or spont mode Volume This loop represents one complete Respiratory cycle (one breath) Inspiratory loop patient pulls a negative pressure to inhale the required tidal volume Expiratory loop patient pushes a positive pressure to exhale the tidal volume Negative pressure Positive pressure Peep level (5 CmH20)

  35. Pressure volume loop through fluidic flip systemnFlow. Volume This loop represents one Complete respiratory cycle (one breath). Inspiratory loop patient pulls a very negative pressure to inhale the required tidal volume Expiratory loop patient pushes a very small positive pressure to exhale the tidal volume Negative pressure Positive pressure Peep level (5 CmH20)

  36. Pressure volume loop through a bubble type CPAP, or device with no fluidic flip Volume This loop represents one complete Respiratory cycle (one breath) Inspiratory loop patient pulls a very small negative pressure to inhale the required tidal volume Expiratory loop patient pushes a positive pressure to exhale the tidal volume Increased expiratory pressure due to no flip in CPAP design. Negative pressure Positive pressure Peep level (5 CmH20)

  37. Heated wire update 22mm Flextube. (Silver Knight) 30mm BIPAP. Low flow 15mm issues. Neonatal systems.

  38. Adult heated wire systems 2026310 now focus product, reconfigured for improved performance. Market success in the UK directly against RT 300 permeable system. Filter can be used at expiratory port (1644). F&P plan new device 12 to 18 months time.

  39. Silver Knight heated wire system Four options are now set up Dual and single heated with and without chamber. Emailer has been sent out to all sales teams Available from stock..

  40. 30mm BIPAP heated wire system Coiled wire system 30mm outer tube Gas velocity is slower increasing heated wire efficiency. Positioned to support heated wire sales, and provide total package.

  41. Low flow Paed/Neonatal heated wire systems This is now an issue with the increase in high tech ventilators with Neonatal ventilation modes. Example Drager Evita 4 with Neomade has been sold to compliment the babylog 8000. New machines have lower flow through the breathing system. If less that 4 litres in one minute low flow system should be used.

  42. Neonatal breathing systems Options increased to ensure all variations for each type of ventilator. New catalogue detailing new range is being prepared. Modular system now included.

  43. Active humidification Strategy • Gain market share, for new technology coming in the near future. • Dehumidification device for field evaluation at the end of 2012 • Own label humidifier early 2013 for export markets. • Upgrades in Humidifier base units in the planning stage.

  44. Transport systems • Two new adult systems for the Drager Oxilog • 2.0m and 3.0m. • Only for machines set for disposable systems. • Includes flow sensor connector. • Completer range to be detailed in Info Sheet.

  45. Critical Care Personnel Bill Barnes CC Group Product Manager. Subs USA. Pauline Quinn Marketing Specialist. Simone Goebel Oral Care Product Manager / Specialist. Subs Spain. Germany. Holland. Export Area Elisabeth Morris. Jaap Roland Speet. Tony Simpson Equipment Product Manager. Jo Ball CC Product Specialist. Subs UK. France. Export Areas Mark Ellis. Meilute Milisauskiene. David Hill. Elsbieta Koenig. Roberto Ranalli CC Product Specialist. Subs Portugal. Italy. Russia. South Africa. Czech Republic. Export Areas Asmat Sameja. Marina Price. Ken Fukuda CC Product Specialist. Subs Japan. China. Taiwan. Philippines. Export Areas NG Edwin Seiw Huat. Rommel Silva.

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