Mirage Swift II Nasal Pillows System Chat Transcript Summary

April 17, 2007

Tonight our special guest speaker is Allen Ehrlich, Director, Product Management, Americas . He has worked in product management for ten years, previously with Kimberly/Clark and Safeskin. Since joining ResMed he has launched the Ultra Mirage full face mask, Mirage Activa nasal mask, and the original Mirage Swift mask.

1. Why did you develop the new Mirage Swift II?
2. Did you market trial the Mirage Swift II prior to bringing this product to market?
3. Why has the Mirage Swift been so successful?
4. Tell us about the new Mirage Swift II.
5. What are the key benefits/features of the Mirage Swift II?
6. Is the Mirage Swift II as quiet as it claims?
7. Do all manufacturers use this ISO standard?
8. Can you give us a real world example of how the Swift II decrease in noise level may be perceived by the ear?
9. What are the benefits of the new Mirage Swift II with quiet venting?
10. How do I tell the differences between the original Swift and the Swift II?
11. Where are the vent holes for the Mirage Swift II?
12. How do I tell if I have the right pillow for Swift II?
13. Does the frame have two rows of small vent holes or is it solid?
14. Does the frame clip have a solid or opening to it?
15. Can you interchange the Swift pillow with the Swift II pillow?
16. How do I attach the new clip?
17. How many tubing positions are there with the Swift II?
18. Does the Mirage Swift II allow you to sleep on your side?
19. What benefit does the choice of side for the tubing entry have if a patient rolls from side to side during the night?
20. Is the headgear material breathable like your other Mirage mask systems?
21. What makes Breathe-O-Prene better?
22. Do the Mirage Swift II pillows fit right into the nostrils?
23. If they don't go inside the nostril, how can the system provide an adequate seal?
24. How many sizes of the Mirage Swift II will my sleep lab need to stock?
25. Does the Mirage Swift II include a pressure port to feed in oxygen or measure pressure?
26. Is it better to position the tubing over the head or downward?
27. I am a smaller female patient on CPAP. There are not many masks out there that will fit me. Is the Mirage Swift II available in a small size?
28. Is the headgear available in different colors or sizes?
29. Most masks I've seen have headgear clips that really help when I take my mask off. Why doesn't the Mirage Swift II have any headgear clips?
30. Is there a fitting template for Mirage Swift II?
31. How easy is this system to set up on a patient?
32. Does it come in a travel bag?
33. Isn't it difficult to switch sleeping positions from side to side when the tube will stick out on one of the sides?
34. Does it come with a user guide to help me understand how to use it?
35. With the tubing being on one side or the other, doesn't this cause unequal distribution of weight and therefore air leaks?
36. I heard you have to develop callouses in order to use nasal pillows, is this true?
37. What mask setting do you use on the AutoSet ™ flow generators?
38. Can you use the Mirage Swift II with a ResMed AutoSet or EPR™ device?
39. Does the Mirage Swift II work with other manufacturers' auto-titrating devices?
40. How much does the Mirage Swift II cost?
41. Is the Mirage Swift II approved for multi-patient, multi-use?
42. How do I clean the Mirage Swift II?
43. What type of soap should the Mirage Swift II be washed with?
44. Is the Mirage Swift II latex-free?
45. Can I order spare parts for the Mirage Swift II?
46. What has been the general feedback about Mirage Swift II so far?
47. Are you able to have two different sizes of pillows on?
48. Are the straps on the side of the face of rigid plastic or neoprene?
49. In pictures, it appears that the nasal pillows put a lot of pressure on the nose. Is this just how it looks in the pictures or how it really is to the user?
50. Has ResMed considered making a third optional spot to attach the hose of the Mirage Swift II, for example, in the center?
51. What should I do if I hear air leaks?
52. What is the easiest way to remove the Mirage Swift II?
53. When you place the headgear on the head and place the pillows at the entrance of the nostrils, which direction should the air vent holes face?
54. When adjusting the headgear straps, which one should be adjusted first?
55. What is the purpose of the rotating elbow and swivel?
56. What are the Medicare reimbursement codes for the Mirage Swift II?
57. What is the difference between nasal prongs and nasal pillows?
58. At what pressures can the Mirage Swift II be used with your flow generators?
59. How do I know if I have a good fit?
60. What should I avoid in fitting?
61. How do I know if the pillow size is too small?
62. How do I know if the pillow size is too large?
63. What is the tube retainer used for?

 

1. Why did you develop the new Mirage Swift II?
   We developed it based on the input of our customers, patients, clinicians, and physicians as to how could we make the popular Mirage Swift even better. We obtained feedback at conferences, on Talk About Sleep and meeting with patients and clinicians.
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2. Did you market trial the Mirage Swift II prior to bringing this product to market?
   Yes, the product had already been launched in Europe last winter and we also conducted user evaluations in the US . Overwhelmingly, Swift users preferred the Swift II.
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3. Why has the Mirage Swift been so successful?
   Because many people prefer an unobtrusive, lightweight and flexible mask that also provides a clear field of vision.
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4. Tell us about the new Mirage Swift II.
   The new Mirage Swift II is one of the quietest and lightest nasal pillow masks on the market. It is 86% quieter than the Mirage Swift and weighs less than 2.5 ounces (about 72 grams)
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5. What are the key benefits/features of the Mirage Swift II?
   The Mirage Swift II builds upon the success of the popular Mirage Swift in that it continues to offer lightweight design weighing less than 2.5 ounces (72 grams) four interchangeable tubing positions (up, down, left or right) to allow for side sleeping. In addition, the Mirage Swift II now offers a new quiet air vent that delivers air quietly and gently away from the patient and bed partner.
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6. Is the Mirage Swift II as quiet as it claims?
   Yes, we can compare how quiet one device is to another by using an international (ISO standard. ISO 3744: 1994 Accoustics Determination of Sound Power to measure the noise levels). The sound measurement comparison used is decibels or dBA. Sound pressure is measured at the mask at 10 cm H 2 0
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7. Do all manufacturers use this ISO standard?
   Yes, this standard is the agreed upon measurement for testing.
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8. Can you give us a real world example of how the Swift II decrease in noise level may be perceived by the ear?
   Swift: A person whispering 3.3 feet (1 meter) away from you vs. Swift II: A person whispering 9.8 feet (3 meter) away from you.
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9. What are the benefits of the new Mirage Swift II with quiet venting?
   The new Mirage Swift II is 86% quieter than the Mirage Swift (Source: testing per ResMed using ISO 3744: 1994). In addition, the newly designed air vent directs air away from the patient and bed partner's face for more comfortable therapy. The vent has also been modified to direct air downward; in a direction more aligned with natural breathing. The Mirage Swift II also has a new blue end cap at the end of the frame to differentiate it from the Swift and also to aid with assembly/disassembly.
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10. How do I tell the differences between the original Swift and the Swift II?
    Great question. We have made it easy. Our website has a simple comparison guide that identifies the product differences between the Mirage Swift II. Go to www.resmed.com under Mirage Swift II to view the comparison.
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11. Where are the vent holes for the Mirage Swift II?
    The vent holes are located in the frame. There are 38 smaller holes in the frame compared to 6 holes in the cushion for Swift.
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12. How do I tell if I have the right pillow for Swift II?
    The Swift II has the ResMed logo molded on the front of the pillow. The original Swift has 6 vent holes on the pillow.
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13. Does the frame have two rows of small vent holes or is it solid?
    The Mirage Swift II has vent holes in the frame while the Swift has no vent holes in the frame.
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14. Does the frame clip have a solid or opening to it?
    The Mirage Swift II has an opening while the original Swift II is solid
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15. Can you interchange the Swift pillow with the Swift II pillow?
    No, we have designed the mask so the new pillow cannot fit onto the old Swift frame. The Swift II pillow has little lugs, or feet, which will not allow it to be seated onto the Swift.
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16. How do I attach the new clip?
    We have improved the retention on the frame clip. The new clip should be pushed on by either end, not in the middle of the clip.
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17. How many tubing positions are there with the Swift II?
    There are four tubing positions with the Mirage Swift II: up on the right, down on the right, up on the left, and down on the left to allow for side sleeping and there is a tube retainer on the mask to keep it attached.
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18. Does the Mirage Swift II allow you to sleep on your side?
    Yes, the mask is designed allows you rotate the pillow sleeve assembly and move the short tube into a position so you can sleep on your side with or without the tube.
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19. What benefit does the choice of side for the tubing entry have if a patient rolls from side to side during the night?
    The left or right side chosen for the inlet tube is most likely going to coincide with the side where your flow generator is located. This allows plenty of freedom for the main 2 m (6.5 ft) tubing to move during sleep without pulling on the mask. When the short tubing is attached per instructions, the patient is free to roll side to side without lying on the tubing.
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20. Is the headgear material breathable like your other Mirage mask systems?
    Yes, the headgear uses our special Breathe-O-Prene ® fabric along with stabilizing elements on the headgear to provide for stability and security in the mask.
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21. What makes Breathe-O-Prene better?
    Breathe-O-Prene material actually wicks away moisture rather than collecting it. This keeps the material dry, making it more comfortable.
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22. Do the Mirage Swift II pillows fit right into the nostrils?
    No. Unlike other pillows or prongs that are inserted inside the nostrils and may irritate delicate nasal passages or nasal hairs, the Mirage Swift II pillows rest gently at the opening of the nostrils.
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23. If they don't go inside the nostril, how can the system provide an adequate seal?
    The nasal pillows were designed so that they fit at the entrance of the nostrils. In conjunction with the nasal pillow frame and headgear they provide excellent seal and stability.
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24. How many sizes of the Mirage Swift II will my sleep lab need to stock?
    The Mirage Swift II is available in three sizes. The mask system, however, comes packaged with All three sizes in a custom-designed carry bag. By including all sizes in one product code, there is less inventory to stock and the patient can take home the other sizes should a subsequent refitting be required (eg, the patient finds another size more comfortable after a week of use).
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25. Does the Mirage Swift II include a pressure port to feed in oxygen or measure pressure?
    We offer 2 components for this. One is a distal pressure port that easily fits on to the swivel at the end of the short tube. The other is a pressure port cap that replaces the end cap.
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26. Is it better to position the tubing over the head or downward?
    This is really a matter of personal preference. Our trials showed that patients appreciated the freedom of choice and our engineers have provided them with an ability to move the tubing up or down without any disconnection of components. (Left or right entry is also selectable).
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27. I am a smaller female patient on CPAP. There are not many masks out there that will fit me. Is the Mirage Swift II available in a small size?
    Our patient trial included more petite females as well as larger males. Not only do the three nasal pillow sizes (S, M, L) have a wide fitting range (including smaller faces), but females also reported that the headgear does not disturb the hair as much as conventional designs.
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28. Is the headgear available in different colors or sizes?
    Not at this time. The blue and teal color combination appears to be a generally well accepted color scheme by many patients and is also the visual identification of ResMed's premium Mirage family of masks.
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29. Most masks I've seen have headgear clips that really help when I take my mask off. Why doesn't the Mirage Swift II have any headgear clips?
    The unique design of the mask and headgear allows the system to be removed and fitted to a patient as easily as a baseball cap (simply lift it off or slip it on). The headgear has two buckles. One buckle is on top of the head and one on the back of the head. These are similar to buckles used on backpacks. There's also no need to readjust any straps. This is the easiest-fitting mask ResMed has ever produced.
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30. Is there a fitting template for Mirage Swift II?
    No, it does not require a fitting template because each system includes all three pillows sizes.
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31. How easy is this system to set up on a patient?
    It is extremely simple because you're actually using the pillows themselves to fit the patient. The patient takes home all three sizes so they can switch sizes if they find that after use, they prefer a different size.
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32. Does it come in a travel bag?
    Yes, It comes in a convenient carrying case that is reusable and can be easily placed inside a suitcase, backpack or briefcase.
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33. Isn't it difficult to switch sleeping positions from side to side when the tube will stick out on one of the sides?
    The placement of the tubing is close enough to the front of the face that it does not interfere with sleeping on that side. We've had numerous patients tell us that it hasn't been a problem.
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34. Does it come with a user guide to help me understand how to use it?
    Yes, it comes complete with a quick-fit guide, detailed user instructions, and a CD with fitting and care information.
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35. With the tubing being on one side or the other, doesn't this cause unequal distribution of weight and therefore air leaks?
    The mask is designed so that the frame, headgear, and cushion provide an even distribution of weight regardless of which side the tube is located.
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36. I heard you have to develop callouses in order to use nasal pillows, is this true?
    Absolutely not. The Mirage Swift II nasal pillows rest gently at the entrance of the nostrils and are not inserted inside, nor do they put pressure on your nares. Therefore, it is not necessary to develop callouses. Sometimes people find that using KY ® or Neosporin ® on the nares is helpful if there is a bit of discomfort.
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37. What mask setting do you use on the AutoSet™ flow generators?
    Mirage Swift II uses the Mirage setting or Swift setting depending on the flow generator from ResMed.
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38. Can you use the Mirage Swift II with a ResMed AutoSet or EPR™ device?
    Yes.
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39. Does the Mirage Swift II work with other manufacturers' auto-titrating devices?
    We do not validate any of our patient interfaces with other manufacturers' devices because the software is always changing, giving us no control over ensuring our claims are consistently validated.
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40. How much does the Mirage Swift II cost?
    The Mirage Swift II is priced competitively with other comparable nasal pillows and prongs in the market. Pricing for the system can be obtained from your local distributor.
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41. Is the Mirage Swift II approved for multi-patient, multi-use?
    Yes, the mask is approved for multi-patient, multi-use in hospitals.
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42. How do I clean the Mirage Swift II?
    The pillows and short tube assemblies should be washed every day by using mild soap and warm water, then allowing to air dry. We also recommend that you first wash your face to remove excess oils. The pillows sleeve assembly itself only needs to be disassembled and cleaned once per week.
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43. What type of soap should the Mirage Swift II be washed with?
    Wash the pillow sleeve assembly, short tube assembly and cap with warm, soapy water. Use pure soap, such as unscented Dove. Rinse well and then allow to air dry out of direct sunlight.
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44. Is the Mirage Swift II latex-free?
    Yes.
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45. Can I order spare parts for the Mirage Swift II?
    Yes, a number of components can be ordered, including the headgear and pillows, by contacting your local dealer.
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46. What has been the general feedback about Mirage Swift II so far?
    It has been extraordinarily positive in Europe and around the world. Comments are that it is better than ever, lightweight and super quiet.
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47. Are you able to have two different sizes of pillows on?
    No, we don't recommend it. Our pillow sizes come packed with the two pillows on a sleeve that are attached. This design and the various sizes will fit variances between one nostril to the other. In other words, size medium, for example, will provide comfort, seal and stability even if one nostril size is slightly larger or smaller than the other. The rotating adjustment on the pillow frame allows for adjustments to give additional comfort and fit.
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48. Are the straps on the side of the face of rigid plastic or neoprene?
    There is no neoprene in any part of the headgear. It is made of Breathe-O-Prene material. The side strap has a very soft and flexible amount of plastic for added stability.
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49. In pictures, it appears that the nasal pillows put a lot of pressure on the nose. Is this just how it looks in the pictures or how it really is to the user?
    The Mirage Swift II nasal pillows are designed so that the nostrils rest gently upon them. Nasal prongs are inserted inside the nostrils and can cause greater discomfort. As with any new product, there is often an adjustment period. However, the Mirage Swift II pillows are uniquely designed to maximize comfort and minimize the need to overtighten the headgear or strap down the pillows too tightly.
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50. Has ResMed considered making a third optional spot to attach the hose of the Mirage Swift II, for example, in the center?
    Not at this time, we have no plans to change the design of the Mirage Swift II. The side position of the hose (tubing) allows for greater flexibility to change the position of the tubing. Additionally, with the tubing at the side, it does not cover up the mouth.
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51. What should I do if I hear air leaks?
    If you hear air leaks, adjust the headgear straps and/or angle of the nasal pillows until the leaks are sealed.
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52. What is the easiest way to remove the Mirage Swift II?
    Pull the pillow sleeve assembly away from the nose and lift the headgear over the head like a baseball cap.
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53. When you place the headgear on the head and place the pillows at the entrance of the nostrils, which direction should the air vent holes face?
    The air vent holes should face upward, away from your body. If air is blowing on your chest, the pillow sleeve is on the frame backwards.
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54. When adjusting the headgear straps, which one should be adjusted first?
    First adjust the back strap, then the top strap so that the panels at the front of the headgear rest on the cheekbone. The pillow sleeve should rest above the upper lip.
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55. What is the purpose of the rotating elbow and swivel?
    It allows for adjustment of the angle of the nasal pillows forward or backward so the nasal pillows sit comfortably at the entrance of the nostrils to establish a good seal and optimize comfort. The rotating elbow also offers more sleeping positions, decouples movement of the patient from the tube to reduce tube drag and adds more flexibility to the system.
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56. What are the Medicare reimbursement codes for the Mirage Swift II?
    The guidelines set by Medicare are the same as other nasal pillows on the market. A7034 for nasal application device with positive airway pressure, one per three months, A7035 for headgear used with positive airway pressure (PAP) device, one per six months; and A7033 for replacement pillows for nasal application device, 2 pairs per month. Check with your insurance company for coverage as all are different.
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57. What is the difference between nasal prongs and nasal pillows?
    The Mirage Swift II is made with pillows that sit at the rim of the nostrils and seal without excessive pressure. Prongs insert directly into the nostrils and can create pressure areas inside the nostrils.
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58. At what pressures can the Mirage Swift II be used with your flow generators?
    The Mirage Swift II is tested and can be used with pressures from 4-20 cm H 2 0.
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59. How do I know if I have a good fit?
    Pillows should sit snugly at the entrance of the nostrils, the pillow sleeve should rest comfortably on the upper lip, the headgear panels should sit between the ear and eye, and the ear should be free from headgear contact.
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60. What should I avoid in fitting?
    Heads traps should not be overtightened because it causes panel distortion and marks on the face. The pillows should not cause nasal flaring, or distortion of the nose or excessive air leaks.
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61. How do I know if the pillow size is too small?
    There will be visible gaps between the pillows and nostrils, as well as uncontrollable air leaks.
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62. How do I know if the pillow size is too large?
    There will be nasal flaring, pillows will protrude from the nostrils, and there will be pressure points in the nose.
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63. What is the tube retainer used for?
    The tube retainer is attached to the top of the headgear on either the left or right side to hold the tube if the tubing is positioned above the head.
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