Download - Oral Therapy and Care for Neonates
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Petite Swabs& Oral Care Kits
®Plak-Vac
Oral Therapy and The Use of Mother’s Milk
in the Treatment of Neonates
Clinical Update
Oral Therapy
Oropharyngeal Administration of
Colostrum
Oropharyngeal Administration of
Mother’s MilkOral
Hygiene
Developmental Support
Exposure to Immune System Agents
Infection Prevention
Expected Benefits
Shorter length of stay
Expected OutcomesReduced time to oral feeds
Fewer infections
Lower cost of care
Reduced time to enteral feeds
Healthy oral tissue
Seed the oral cavity with sIgA, interleukins lactoferrin, lysozyme and oligosaccharides.
Introduce taste & smell of mother’s milk toencourage maternal bonding, development of non-nutritive sucking, and calming/soothing.
Regular cleaning and moisturizing help reduce the possibility of healthcare-acquired infection and maintain good oral tissue health.
NPO and Tube Fed Babies
Extremely/Very Low Birthweight Babies
All Babies/Babies on Respiratory Support
Breast milk has been shown to confer a variety of immunological, health and developmental benefits to orally fed babies, including improving outcomes such as decreased HAI, incidence of necrotizing enterocolitis, length of stay, and infant neurodevelopment.(1) Unfortunately, clinical instability in ELBW and VLBW precludes feeds, and these babies do not enjoy the benefits of colostrum or mother’s milk until feeds begin, which given the standard clinical practice of delaying feeding for up to 8 weeks in the ELBW baby, increases the risk of intestinal atrophy and necrotizing enterocolitis.(2,3,4)
Recent clinical work by Rodriguez,(2,3,4) Seigel,(5) and Montgomery(6) suggest there may be meaningful benefits from the oropharyngeal administration of colostrum to very- and extremely-low-birth weight babies. It is thought that immune factors, which are at the highest levels in colostrum, may be absorbed by the mucous membranes, interact with and stimulate immune tissue in the oral cavity, and provide local barrier protection against pathogens.(2,3,4) Additionally, healthy bacteria found in mother’s milk may have a probiotic effect: the oral cavity of neonates lacks endogenous microbial flora, and the beneficial bacteria from milk can “seed” the oral cavity and provide additional protection against oral pathogens.(1,7)
A recent randomized controlled trial in extremely low birth weight babies found that there was a statistically significant reduction (10 days) in the time to reach full enteral feedings for babies receiving oropharyngeal administration of mother’s colostrum.(2,3,4)
1. Thibeau, S. et al., Exploring the Use of Mothers’ Own Milk as Oral Care for Mechanically Ventilated Very Low-Birth-Weight Preterm Infants. Advances in Neonatal Care Vol 13, No. 3, pp. 190-197.2. Rodriguez, N. et al A Randomized Controlled Trial of Oropharyngeal Administration of Mother’s Colostrum to Extremely Low Birthweight Infants in the First Days of Life. Neonatal Intensive Care Vol 24 No. 4 July-August 2011.3. Rodriguez, N. et al. A Pilot Study to Determine the Safety and Feasibility of Oropharyngeal Administration of Own Mother’s Colostrum to Extremely Low-Birth-Weight Infants. Advances in Neonatal Care Vol. 10, No. 4 pp. 206-2124. Rodriguez, N. et al. Oropharyngeal administration of colostrum to extremely low birth weight infants: theoretical perspectives. J Perinatol. 2009 January; 29(1): 1-7.5. Siegel, J. et al. Early Administration of Oropharyngeal Colostrum to Extremely Low Birth Weight Infants. Breastfeeding Medicine Volume 8, Number 0, 2013.6. Montgomery, D.P. et al. Oropharyngeal Administration of Colostrum to Very Low Birth Weight Infants: Results of a Feasibility Study. Neonatal Intensive Care Vol 23, No. 1 January-February 2010. 7. Brady, T. Health care-associated infections in the neonatal intensive care unit. American Journal of Critical Care, 2005; 33:268-275.8. Hylander MA et al. Human Milk Feedings and Infection Among Very Low Birth Weight Infants. Pediatrics 1998;102(3).
Complex carbohydrate molecules that inhibit the adhesion of pathogens on the epithelial surface and interact with immune cells.(2,3,4)
Immune Factor Mechanism of Action
Secretory Immunoglobulin A (sIgA) Inhibits attachment of pathogens to respiratory and intestinal mucosal tissue.(2,3,4)
Interleukin-6Interleukin-10
Immunomodulators that may stimulate sIgA production in the lymphoid cells of the oral cavity.(2,3,4)
Lactoferrin Iron-binding protein with antimicrobial and antiviral properties.(2,3,4)
Lysozyme Enzyme that attacks and damages the cell wall of bacteria, especially gram-positive bacteria.(8)
Human Milk Oligosaccharides
Direct absorption of immunologic agents throughthe oral mucosa.
Faster time to full enteral feeds- 10 days sooner andshorter length of stay.
Objective
Potential Clinical Outcomes
Oropharyngeal Administration of Colostrumin Extremely and Very Low Birthweight NPO Babies
Exposure to immunologic agents including:sIgA, interleukins, lactoferrin, lysozyme, andoligosaccharides.
Application of colostrum directly to the orpharnygeal mucosa.
Treatment
Expected Clinical Benefits
449 Sovereign Court
St. Louis, MO 63011
Phone: 636-527-2288
Disclaimer: This information is provided by Trademark Medical as an informational service, and is not intended to substitute for professional medical judgment in the treatment of patients, nor does this information in any wayinfer the marketing or sale of Trademark Medical products beyond the limitations of FDA regulation. M1024B
Developmental Care Benefits: Taste and Smell
The taste and smell of mother's milk helps babies identify their mother and creates an important bond between mother and baby. Additionally, exposure to the taste and smell of mother’s milk may facilitate the development of feeding skills and produce a calming effect on the baby.
Babies “respond positively” to the taste and smell of mother’s milk, and exposure to mother’s milk facilitates recogni-tion of the mother.(1) Babies not orally fed (ie, NPO, ventilated, tube feeders) do not have the opportunity to develop a taste for mother’s milk, which could potentially contribute to oral aversion and delayed development of feeding skills. One study notes that babies who had the oral mucosa swabbed with colostrum “appeared to taste” the colostrum as noted by sucking on the breathing tube.(3,5) This non-nutritive sucking can produce an analgesic and calming effect,(6) and may help in the transition from tube feeding to bottle feeding.(7)
Improved Clinical Outcomes
Evidence suggests the application of mother’s milk to the oral cavity could improve clinical outcomes. In naso- and oro-gastrically fed infants, the taste and smell of mother’s milk was shown to increase intake, weight gain, and growth, and shorten the length of hospitalization by 4 days.(1,8) Preterm infants exposed to breast milk odor during gavage feeding made the transition to oral feeding 3 days sooner,(8) and pilot studies have shown a reduction in the time to beginning full enteral feeds.(2,3)
1.Browne, J Chemosensory Development in the Fetus and Newborn. Newborn & Infant Nursing Reviews, December 2008 Vol 8, Number 4 www.nainr.com2.Rodriguez, N. et al A Randomized Controlled Trial of Oropharyngeal Administration of Mother’s Colostrum to Extremely Low Birthweight Infants in the First Days of Life. Neonatal Intensive Care Vol 24 No. 4 July-August 2011.3.Rodriguez, N. et al. A Pilot Study to Determine the Safety and Feasibility of Oropharyngeal Administration of Own Mother’s Colostrum to Extremely Low-Birth-Weight Infants. Advances in Neonatal Care Vol. 10, No. 4 pp. 206-2124.Rodriguez, N. et al. Oropharyngeal administration of colostrum to extremely low birth weight infants: theoretical perspectives. J Perinatol. 2009 January; 29(1): 1-7.5.Thibeau, S. et al., Exploring the Use of Mothers’ Own Milk as Oral Care for Mechanically Ventilated Very Low-Birth-Weight Preterm Infants. Advances in Neonatal Care Vol 13, No. 3, pp. 190-197.6.Bingham, P et al. A Pilot Study of Milk Odor Effect on Nonnutritive Sucking by Premature Newborns. Arch Pediatr Adolesc Med/ Vol 157, Jan 20037.Raimbault, C. et al, The effect of the doour of mother’s milk on breastfeeding behaviour of premature neonates. Acta Paediatrica 2007 96, pp 368-371.8.Yildiz, A. The Effect of the Odor of Breast Milk on the Time Needed for Transition From Gavage to Total Oral Feeding in Preterm Infants. Journal Nursing Scholarship, 2011: 43:3, 265-273
Enhance Maternal Bonding(1)
StimulateNon-Nutritive Sucking(4)
Mitigate Oral Aversion(4)
Calm and Soothe Baby(1)
Faster Transitionto Oral Feeding(8)
Faster Transitionto Enteral Feeding(4)
Shorter Length of Hospitalization(8)
DevelopmentalBenefits
PotentialOutcomes
Potential Benefits of Mother’s Milk as Oral Therapy
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Oropharyngeal Administration of Mother’s Milkin NPO and Tube Fed Babies
Introduce taste and smell of mother/mother’s milk to babies that are not feeding orally.
Encourage maternal bonding, development of non-nutritive sucking, and calming/soothing.
Application of mother’s milk directly to the orpharnygeal mucosa.
Treatment Objective
Potential Clinical OutcomesShorten time to full oral feeds- 3 days sooner,reduce length of stay- 4 days, and possibly reduce oral aversion.
Expected Clinical Benefits
449 Sovereign Court
St. Louis, MO 63011
Phone: 636-527-2288
Disclaimer: This information is provided by Trademark Medical as an informational service, and is not intended to substitute for professional medical judgment in the treatment of patients, nor does this information in any wayinfer the marketing or sale of Trademark Medical products beyond the limitations of FDA regulation. M1025B
Babies are unable to provide their own oral care or communicate oral discomfort or needs, therefore oral care must be provided by a caregiver. Poor oral hygiene can lead to excessive bioburden in the oral cavity, resulting in the deterioration of oral tissue health, and the potential for aspiration of highly virulent secretions. Healthy oral tissue helps maintain integrity of the oral cavity’s natural immunological capabilities,(1) therefore, it is desirable to preserve healthy oral tissue to help prevent systemic disease.
In light of these factors, the CDC suggests that health care facilities develop and implement a comprehensive oral hygiene program for patients in all acute care settings, including those in the neonatal intensive care unit (2), and the IHI recommends “comprehensive mouthcare appropriate to the age of the patient” as part of their Pediatric Ventilator-Associated Pneumonia (VAP) Change Package.(3) These recommendations have been implemented by the vast majority of adult ICU’s, as well as many PICU’s, with formal oral care protocols defining a standard of care for these patient populations.
Neonates can also benefit from the development of standardized oral care protocols. Newborns have unique characteristics which predispose them to infection, including 1) an immature immune system with abnormal granulo-cyte migration and bacterial digestion, decreased activity of complement, particularly complement opsonization and low immunoglobulin G (IgG) levels,(4) 2) permeable skin and mucus membranes,(1,5) 3) a lack of endogenous micro-bial flora (1,5) and 4) frequent blood draws that decrease levels of immunological agents.(1) These factors create the possibility that oral flora may not develop “normally” in NICU babies, and initial colonization may include potentially harmful bacteria present in the NICU, e.g., K. pneumoniae, E. coli, P. aeruginosa, and S. aureus,(1,6,7) possibly leading to healthcare acquired infection and deterioration of oral tissue.
1. Brady, T. Health care-associated infections in the neonatal intensive care unit. American Journal of Critical Care, 2005; 33:268-275.2. Garland, L.S. (2010). Strategies to prevent ventilator-associated pneumonia in neonates. Clinics in Perinatology, 37, 629-643.3. http://www.ihi.org/knowledge/Pages/Tools/HowtoGuidePreventVAPPediatricSupplement.aspx.4. Foglia, E., Meier, M.D., & Elward, A. (2007). Ventilator-associated pneumonia in neonatal and pediatric intensive care unit patients. Clinical Microbiology Reviews, 20(3), 409-425.5. Donowitz,G., Nosocomial infection in neonatal intensive care units. Am J Infect Control 1989;17:250-76. Makhoul, I et al. Factors influencing oral colonization in premature infants. IMAJ 2002;4:98-1027. Goldmann, D et al. Bacterial colonization of neonates admitted to an intensive care environment. Journal of Pediatrics 1978;2:288-293.8. Stefanescu, B. et al., A Pilot Study of Biotene OralBalance Gel for Oral Care in Mechanically Ventilated Perterm Neonates. Contemporary Clinical Trials 35 (2013) 33-399. Schooley, K., et al., Quality Improvement Project: Decreasing Ventilator Associated Pneumonia Rate in our NICU at Overland Park Regional Medical Center. Vermont Oxford Network. http://www.vtoxford.org/meetings/AMQC/Handouts2012/LearningFair/OverlandParkRegional_DecreasingVentilationAssociatedPneumonia.pdf10. Ceballos, K. et al., Nurse-Driven Quality Improvement Interventions to Reduce Hospital-Acquired Infection in the NICU. Advances in Neonatal Care 2013 Vol 13, No. 3 pp 154-163.11.http://www.ihi.org/offerings/MembershipsNetworks/MentorHospitalRegistry/Documents/Central%20DuPage%20-Creating%20and%20Implementing%20a%20Bundle%20to%20Reduce%20VAP%20in%20the%20 NICU%202011.pdf12. Wilson, S. et al Oral Care in the Neonate: One Step in a Bundle To Reduce Ventilator Associated Pneumonia (VAP). Pediatric Academic Societies Poster Session E-PAS2012:1519.349.
Bacterial colonization of the oral cavity was reduced by 54%, and gram negative colonization was eliminated in 33% of affected patients in a pilot study utilizing a q6 oral care regimen with water or mother’s milk.(12)
VAP rates were reduced to zero after implementation of a bundle including a q3-4 oral care protocol using mother’s milk, Biotene OralBalance Gel or sterile water. (11)
VAP rates declined 71% in a study utilizing a q3-4 oral care protocol with mother’s milk or sterile water as part of a ventilator bundle. (10)
VAP rates declined after the implementation of a VAP bundle including a q4 oral care protocol using mother’s milk or sterile water. (9)
Oral Hygienefor All Babies and Babies on Respiratory Support
Reduce bioburden in the oral cavity, stimulate oral tissue, and minimize drying of oral tissue lips and nares.
Clean and moisturize the oral cavity of all babies,and particularly those on respiratory support- ie., ventilators, CPAP.
Reduce the possibiliity of healthcare acquired infection and maintain good oral tissue health.
Prevent ventilator-associated and hospital acquiredpneumonias, minimize potential for systemic infection and oral lesions.
Treatment Objective
Potential Clinical OutcomesExpected Clinical Benefits
Potential Benefits of a Standardized Oral Hygiene Regimen
449 Sovereign Court
St. Louis, MO 63011
Phone: 636-527-2288
Disclaimer: This information is provided by Trademark Medical as an informational service, and is not intended to substitute for professional medical judgment in the treatment of patients, nor does this information in any wayinfer the marketing or sale of Trademark Medical products beyond the limitations of FDA regulation. M1026A
The Potential Impact of Oral TherapyImproved Clinical Outcomes
Lower Costs and Other Benefits
Healthy Oral Tissue
1. Rodriguez, N. et al A Randomized Controlled Trial of Oropharyngeal Administration of Mother’s Colostrum to Extremely Low Birthweight Infants in the First Days of Life. Neonatal Intensive Care Vol 24 No. 4 July-August 2011.2. Yildiz, A. The Effect of the Odor of Breast Milk on the Time Needed for Transition From Gavage to Total Oral Feeding in Preterm Infants. Journal Nursing Scholarship, 2011: 43:3, 265-273.3. Wilson, S. et al Oral Care in the Neonate: One Step in a Bundle To Reduce Ventilator Associated Pneumonia (VAP). Pediatric Academic Societies Poster Session E-PAS2012:1519.349.4. Ceballos, K. et al., Nurse-Driven Quality Improvement Interventions to Reduce Hospital-Acquired Infection in the NICU. Advances in Neonatal Care 2013 Vol 13, No. 3 pp 154-163.5. Russell, B et al., Cost of Hospitalization for Preterm and Low Birthweight Infants in the United States. Pediatrics 2007;Volume 120, Number 1 July 2007:e1-e9.
Day
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Length of Stay Enteral Feeds0
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A 3 day reduction in time to full oral feeds and a 4 day reduction in length of stay was shown in tube fed babies exposed to the smell of mother’s milk.(2)
Treatment Group
Control Group
Reduced Time to Oral Feeds & Shorter Length of Stay
VAP rates declined 71% in a study utilizing a q3-4 oral care protocol with mother’s milk or sterile water as part of a ventilator bundle.(4)
Treatment Group
Control Group
Fewer Infections
A pilot study in very low birthweight babiesusing oropharyngeal administration of colostrum showed a 10 day reduction in time to enteral feeds.(1)
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20
25
Treatment Group
Control Group
Reduced Time to Enteral Feeds
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3
6
9
12
15
Bacterial colonization of the oral cavity was reduced by 54%, and gram negative colonization was eliminated in 33% of affected patients, in a pilot study utilizing a q6 oral care regimen with water or mother’s milk.(3)
Treatment Group
Control Group
Colonized Gram Negative
Pat
ient
s
VAP
Rat
e
0
5,000
10,000
15,000
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$35,000
Lower Cost of Care
A 4 day reduction in length of stay, from 23 to 19 days,(2) yields a 17% cost savings based on a $1,500 average per day cost of treat-ment in the NICU(5)
$34,500
$28,500 } $6,000 Savings
In addition to direct cost savings, indirect benefits may accrue from a comprehensive oral therapy program:
Babies may be calmed and comforted by mother’s milk.
Maternal bonding is encouraged both by acclimating the baby to the mother’s smell, and by parental participation in oral therapy.
Non-nutritive sucking may be stimulated.
Oral aversion may be mitigated by introducing the taste of mother’s milk.
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Disclaimer: This information is provided by Trademark Medical as an informational service, and is not intended to substitute for professional medical judgment in the treatment of patients, nor does this information in any way infer the marketing or sale of Trademark Medical products beyond the limitations of FDA regulation.
*Lansinoh is a registered trademark of Lansinoh Laboratories, Inc. Alexandria VA *Ayr is a registered trademark of BF Ascher & Co, Inc, Lenexa KS *Little Sucker is a registered trademark of Neotech Products, Inc. Valencia, CA *Biotene is a registered trademark of GlaxoSmithKline LLC Wilmington DE *Bebeonker is a registered trademark of Small Beginnings, Inc. Hesperia, CA
Disclaimer: Trademark Medical makes no claim of safety or efficacy for any products used in Plak-Vac Oral Care Kits beyond those made by the product manufacturer’s legally approved claims and indications for use.
Made in U.S.A. M1023B
449 Sovereign Court
St. Louis, MO 63011
Web: www.trademarkmedical.com
Phone: 636-527-2288
Order Now:Call: 800-325-9044Fax: 636-527-0255
Plak-Vac Petite Swabs
®®®
IV Pole Hanger
Suction Catheters 8,10,12 Fr.Small Beginnings Bebeonkers*
Neotech Little Sucker*Preemie or Standardwith or without Cover
Sterile Water 5 mlBiotene* Oral Balance
Gel 3g
White Petrolatum 5gLansinoh* Lanolin
Ayr* Saline Gel 0.5 ozSaline Wipes Medicine Cup
2” x 2” Gauze
Sterile Saline 5 ml
Oral Suction & OptionsCleanser & Moisturizer Options
8 mmHead
6 mmHead
12 mmHead
(Actual) Size)
LAHead
Change kit on:
Mon Tues Wed Thur Fri Sat SunThis kit is intended for 24 hours of oral care. Single patient use.
Kit Contents:6 - Petite Applicator Swab – 6 mm6 - Petite Applicator Swab – 8 mm6 - Sterile Water – 5 ml
Order No.Lot No.
Contents are Non SterileExp Date:
St. Mary’s Medical Centerq4 Petite Oral Care Kit
Manufactured for:
St. Louis, MO 63011800-325-9044
Oral Care Procedure
¾ Use contents as directed by Oral Care Protocol to clean patient’s oral cavity.
Pouch Contents
Petite Swab 6 mmPetite Swab 8 mm
Sterile Water
Contents are Non-Sterile
04:00-06:00 Hours
Oral Care Procedure
¾ Use contents as directed by Oral Care Protocol to clean patient’s oral cavity.
Pouch Contents
Petite Swab 6 mmPetite Swab 8 mm
Sterile Water
Contents are Non-Sterile
00:00-02:00 Hours
Oral Care Procedure
¾ Use contents as directed by Oral Care Protocol to clean patient’s oral cavity.
Pouch Contents
Petite Swab 6 mmPetite Swab 8 mm
Sterile Water
Contents are Non-Sterile
20:00-22:00 Hours
Oral Care Procedure
¾ Use contents as directed by Oral Care Protocol to clean patient’s oral cavity.
Pouch Contents
Petite Swab 6 mmPetite Swab 8 mm
Sterile Water
Contents are Non-Sterile
16:00-18:00 Hours
Oral Care Procedure
¾ Use contents as directed by Oral Care Protocol to clean patient’s oral cavity.
Pouch Contents
Petite Swab 6 mmPetite Swab 8 mm
Sterile Water
Contents are Non-Sterile
12:00-14:00 Hours
Oral Care Procedure
¾ Use contents as directed by Oral Care Protocol to clean patient’s oral cavity.
Pouch Contents
Petite Swab 6 mmPetite Swab 8 mm
Sterile Water
Contents are Non-Sterile
08:00-10:00 Hours
Kit Change Indicator
Timed Treatment Packets
Customer-Specified Protocol
Customized Contents
Plak-Vac Petite Daily Kits
Plak-Vac tailor-made daily kits organize all components at the point-of-care to enhance protocol compliance and support infection control policies. Choose from our size-appropriate Petite swabs and a variety of options for cleaning, moisturizing, and suctioning the oral cavity.
Plak-Vac® Petite products support all oral therapy needs
A New Standard of Oral Care for the NICU
449 Sovereign Court
St. Louis, MO 63011
Web: www.trademarkmedical.com
Phone: 636-527-2288
Made in U.S.A. M1027B
Order Now:Call: 800-325-9044Fax: 636-527-0255
Petite Low Absorption SwabPlak-Vac® Oral Care
Plak-Vac Petite LA Swab (actual size)
TM®
The Plak-Vac®
Petite LATM
low absorption swab was developed for applications where the loss
of oral therapy solution (e.g., colostrum) must be minimized. The Petite LA swab is size
appropriate for even the smallest babies and features a soft, non-shedding foam head that will
not lint or fray when wet, and a smooth polypropylene handle rather than wood.
0
20
40
60
80
100
% o
f 0
.2 m
l d
ose
Fluid Retained by SwabFluid Delivered
Cotton Tipped
Applicator
Plak-Vac
Petite LA Swab
Treatment Dose Application Swab Test Results
Due to it’s low absorption and
small head, the Petite LA swab is
ideal for applications such as the
oropharyngeal administration of
colostrum as described by
Rodriguez at al.*
The Petite LA swab can be
incorporated into a Plak-Vac oral
care kit to support an oropharyn-
geal colostrum administration
protocol, by combining the swab
with other components such as
a 1 cc syringe, gauze pads,
sterile water, gloves, and other
accessories.
Change kit on:
Mon Tues Wed Thur Fri Sat SunThis kit is intended for 24 hours of oral care. Single patient use.
Kit Contents:6 - Petite Applicator Swab – 6 mm
6 - Petite Applicator Swab – 8 mm
6 - Sterile Water – 5 ml
Order No.Lot No.
Contents are Non SterileExp Date:
St. Mary’s Medical Centerq4 Petite Oral Care Kit
Manufactured for:
St. Louis, MO 63011
800-325-9044
Oral Care Procedure
¾ Use contents as directed
by Oral Care Protocol to
clean patient’s oral cavity.
Pouch Contents
Petite Swab 6 mm
Petite Swab 8 mm
Sterile Water
Contents are Non-Sterile
04:00-06:00 Hours
Oral Care Procedure
¾ Use contents as directed
by Oral Care Protocol to
clean patient’s oral cavity.
Pouch Contents
Petite Swab 6 mm
Petite Swab 8 mm
Sterile Water
Contents are Non-Sterile
00:00-02:00 Hours
Oral Care Procedure
¾ Use contents as directed
by Oral Care Protocol to
clean patient’s oral cavity.
Pouch Contents
Petite Swab 6 mm
Petite Swab 8 mm
Sterile Water
Contents are Non-Sterile
20:00-22:00 Hours
Oral Care Procedure
¾ Use contents as directed
by Oral Care Protocol to
clean patient’s oral cavity.
Pouch Contents
Petite Swab 6 mm
Petite Swab 8 mm
Sterile Water
Contents are Non-Sterile
16:00-18:00 Hours
Oral Care Procedure
¾ Use contents as directed
by Oral Care Protocol to
clean patient’s oral cavity.
Pouch Contents
Petite Swab 6 mm
Petite Swab 8 mm
Sterile Water
Contents are Non-Sterile
12:00-14:00 Hours
Oral Care Procedure
¾ Use contents as directed
by Oral Care Protocol to
clean patient’s oral cavity.
Pouch Contents
Petite Swab 6 mm
Petite Swab 8 mm
Sterile Water
Contents are Non-Sterile
08:00-10:00 Hours
Kit Change Indicator
Timed Treatment Packets
Customer-Specified Protocol
Customized Contents
Plak-Vac Oral Care Kits
* Rodriguez, N. et al. A Pilot Study to Determine the Safety and Feasibility of Oropharyngeal Administration of Own Mother’s Colostrum to Extremely Low-Birth-Weight
Infants. Advances in Neonatal Care Vol. 10, No. 4 pp. 206-212
The Petite LA swab retains roughly half
of the fluid a cotton tipped applicator
absorbs- conserving the oral therapy
solution for delivery to the patient rather
than being thrown away with the swab.
Disclaimer: Trademark Medical makes no claim of safety or efficacy for any products used in Plak-Vac Oral Care Kits beyond those made by the product manufacturer’s legally approved claims and indications for use.