Trachi-Naze

Trachi-Naze Hands Free Valves — HFV Troubleshooting Chart

Problem	Possible Cause	Action
Poor seal on baseplate	Poor application technique Stoma position and/or shape of neck, e.g recessed stoma High intra-tracheal pressure	Review application technique. Use adhesive Try different shaped baseplate Consider stoma stud or laryngectomy tube Try larger baseplate or stoma stud in combination with trying to reduce pressure through speech techniques
Red, sore, oedematous skin	Allergy/sensitivity to baseplate Allergysensitivity to adhesive Allergy/sensitivity to cleaning products	Discontinue use to allow skin to improve Try alternative baseplate Consider stoma stud Clean with warm soapy water and rinse well. Do not use household detergents
Air leakage around stoma stud	Stoma stud too small Shape of stoma isn't round	Try larger diameter Try Kapigel (with long stud only)
Stoma stud frequently falling out	Stoma stud too small Length is too short Stoma stud not positioned correctly Patient coughing	Try larger diameter Try long length Review fitting technique to ensure stoma stud is actually fully inserted Remove stoma stud while coughing or place hand in front to secure
Difficulty inserting stoma stud	Unpractised technique Stoma stud very snug or too large	Use a firm twisting motion Lubricate stud with water or water based gel Try smaller size
Difficulty fitting filter into baseplate	Poor dexterity and handling when using twist lock occlusion cap	Change to special occlusion cap Fit filter into special occlusion cap before attaching to baseplate
Coughing	Stoma stud irritating posterior wall As a new wearer, body is adjusting to the “foreign object”	Try shorter length Try Kapigel with long stud to shorten length Consider use of tube or baseplate Persevere with use. Try for short periods
Difficulty with breathing	Body is getting used to return of airway resistance Occlusion at back of stoma stud	Try with orange filter, then build up tolerance to green Initially use at rest and build up tolerance time Ensure correct positioning of stud. Try small length stud Consider laryngectomy tube or baseplate
Sore stoma and/or slight bleeding	Stoma stud too large Crusting at stoma	Allow stoma to heal Assess for correct size Ensure orange filter is only used for short periods as HME effect is reduced
No voice	No seal on baseplate Poor fitting stoma stud Finger not occluding filter correctly Stoma stud occluding voice prosthesis	Ensure adequate sealing Review stud size Use ball of largest finger or thumb. Look in mirror to assess technique Fenestrate stoma stud or tube if necessary
Weak or whispery voice	Hypotonic neoglottis	Try speaking in softer, lower pitch Try change in head position Consider pressure band

As with anything new, e.g.: contact lenses, the body needs time to get used to something different. Normally a period of approximately two weeks is sufficient time to acclimatise to a new feeling and for the body to be less irritated. Perseverance is worth the outcome of improved breathing, more oxygenation, less coughing, less mucous production, having more energy etc.

Be realistic about your expectations in the beginning and do not expect the optimum straight away.

• Trachi-naze HFV Troubleshooting Chart →
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