Abstract: Mouthpiece (1) having vestibular shield (21) overlapping a user's teeth and gums, gases passageway means extending through said vestibular shield allowing for the passage of said gases through mouthpiece and extra oral sealing (25) means associated with gases passageway, said passageway in use causes gases to be diffused (outlets 23, 24) when exiting from gases passageway. Mouth piece may have a noseflap to seal the user's nose or provide a passageway for use'r s nasal passages. Mouthpiece may have adjustment means to alter distance between said vestibular shield and said extra-oral sealing means.

Abstract: Tracheostomy apparatus includes a needle with a doppler ultrasound transducer mounted within it close to its patient end and connected to a monitor. Two electrodes are insulated from one another on the external surface of the needle close to its patient end. The electrodes are also connected to the monitor. The needle supports a catheter on its outer surface. As the needle is inserted through tissue overlying the trachea, the ultrasound transducer detects the presence of any nearby blood vessels and gives an audible indication on the monitor. The monitor also responds to a rise in impedance between the electrodes indicative of entry of the end of the needle into the trachea so that the needle can be removed to leave the catheter in place. A guide is then inserted through the catheter and the path into the trachea is enlarged with a dilator sufficiently to receive a tracheostomy tube.