,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Covidien Respiratory&Monitoring Solutions|,December 2,2019,|Confidential,#,|,Covidien Respiratory&Monitoring Solutions|,December 2,2019,|Confidential,#,|,Click to edit Master title style,Were allowing the market,especially our competitors,to create the perception of who we are rather than taking the lead,Covidien Respiratory&Monitoring Solutions|,December 2,2019,|Confidential,#,|,T,aperGuard,产品培训,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,2,|,TaperGuard:,销售培训内容,TaperGuard,特性介绍,临床背景,关键信息,定位,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,3,|,TaperGuard,TaperGuard,Evac,渐进封闭锥形套囊技术,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,4,|,临床需求发展变化的演变,Intubation,Short Term Intubation,Long Term Intubation,Special OR,Special OR,Removal of bacterial laden secretions.,Modified airway device due to procedure,Provide simple airway,Modified airway device due to procedure,Provide simple airway,1997-2008,1980-1990,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,5,|,微量分泌物误吸现象,:,一个没有被认识到的问题,?,基于现在的套囊技术，手术室中微量分泌物误吸现象很普遍，但是由此引发的严重并发症却很少见。,虽然并发症很少见，一旦发生却是很严重的，因此临床致力于采取多种方式减少误吸现象的发生。,麻醉医生意识到了手术插管中的误吸现象？,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,6,|,临床观点,如果误吸在手术过程中无需引起重视，那么为何医生要采取各种措施减少围手术期误吸现象的发生？,在插管过程中,增加套囊压力,拔管之前 吸引,在峰压时托管,让病人咳嗽,.,虽然医生知道有分泌物在气道中，也采取一定的措施减少误吸，但是他们是否了解目前的套囊设计还是会不可避免的让一部分分泌物流入气道？,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,7,|,锥形的套囊设计使套囊的尺寸在一定程度上正好符合气管的内经。,没有褶皱和漏气通道,确保针对不同形状和大小的气管都有好的封闭效果。,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,8,|,锥形套囊的角度对于其封闭性能至关重要。,套囊的直径和锥形角度能够根据不同的气管直径进行调节，从而很好的进行封闭。,Taper,设计,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,9,|,TaperGuard,套囊是,PVC,材料,产品分类和,Hi-Lo,是相同的，可以分为：,as Hi-Lo for TaperGuard basic and,Hi-Lo Evac for TaperGuard Evac.,例如,.ID/OD/,长度,/,尺寸,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,10,|,产品功能定位,TaperGuard,TaperGuard,Evac,减少误吸,分泌物管理,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,11,|,TaperGuard,平台,TaperGuard endotracheal tube,A Mallinckrodt endotracheal tube with the TaperGuard cuff technology.,TaperGuard Evac endotracheal tube:,A Mallinckrodt endotracheal tube with both the TaperGuard cuff technology and Evac suction lumen.,TaperGuard Evac allows for the active removal of secretions from above the cuff for patients with a higher risk of aspiration.,The Evac lumen may be hooked up to wall suction either continuous low or intermittent high,or a syringe may be used periodically to remove secretions from above the cuff.,TaperGuard,提供两种配置,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,12,|,TaperGuard,技术,It is the unique tapered shape cuff that allows for this significant improvement in tracheal seal.,The large cuff diameter of standard high volume,low pressure cuffs results in excess material that forms folds and channels that serve as a pathway for microaspiration of secretions into the lungs.,The tapered shape cuff of the TaperGuard configuration allows the cuff diameter to match the trachea diameter at a certain point.At this point there is no excess material therefore no folds or channels common with standard high volume low pressure cuffs.,By finding the right fit between the cuff external diameter and the trachea inner diameter the TaperGuard cuff significantly reduces microaspiration by at least 85%compared to conventional high volume low pressure cuffs.,TaperGuard,是如何工作的？,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,13,|,独特的锥形套囊能够在一定位置匹配气管直径大小,在这点最小化皱褶和通道的存在,确保封闭区达到不同插管形状的形状，尺寸大小,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,14,|,如何工作？,套囊近端,:,Cuff diameter Tracheal diameter,封闭带,:,Cuff diameter=Tracheal diameter eliminating excess cuff material locally,Mallinckrodt,TaperGuard ETT,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,15,|,临床背景,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,16,|,误吸及肺炎,1-Nagelhout et al.Aspiration prophylaxis:is it time for changes in our practice?AANA Journal Aug 2003 vol71 no 4,误吸不一定会引发肺炎。,酸性物质的吸入会严重损伤呼吸道，并不一定伴发肺部感染。,起初没有肺部感染症状的患者随着呼吸道损伤的加重及插管时间的延长，可能会逐渐发展成肺炎,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,17,|,手术及术后误吸并发症,手术及术后误吸可能是由于,:,喉痉挛,支气管痉挛,脱管后的咳嗽,低氧血症,吸入性肺炎,(Mendelonsons syndrome),(1),肺炎,气管狭窄,哮喘,急性呼吸窘迫综合症,肌张力过高,心动过缓,心脏停搏,低氧血症,导致,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,18,|,对于呼吸道刺激物的自然反应,通过清除刺激物及分泌物来保护气道,对于患者而言可能非常不舒服,可能会干扰睡眠和正常活动，也可能伴有眩晕，胸痛，呼吸困难。,导致胸廓内压增高,:,外伤患者,肋骨骨折,脊柱损伤,手术患者 伤口疝,;,心胸手术患者,手术患者 腹部手术,咳嗽,Covidien Respiratory&Monitoring Solutions|,November 16,2024,|Confidential,19,|,对肺组织有严重损伤,盐酸引起肺泡毛细血管损伤，从而导致肺水肿，影响肺部气体交换。,破坏肺泡中的血流空气屏障,导致低压肺水肿,严重的通气不平衡,低氧血症和高碳酸血症,死腔永久性的增大,急性呼吸窘迫综合症