Abstract: Quantitative colorimetric carbon dioxide detection and measurement systems are disclosed. The systems can include a gas conduit, a colorimetric indicator adapted to exhibit a color change in response to exposure to carbon dioxide gas, a temperature controller operatively coupled to the colorimetric indicator and configured to control the temperature of the colorimetric indicator, an electro-optical sensor assembly including a light source or sources adapted to transmit light to the colorimetric indicator, and a photodiode or photodiodes configured to detect light reflected from the colorimetric indicator and to generate a measurement signal, and a processor in communication with the electro-optical sensor assembly. The processor can be configured to receive the measurement signal generated by the electro-optical sensor assembly and to compute a concentration of carbon dioxide based on the measurement signal.

Abstract: A device for clearing obstructions from a medical tube, such as a chest tube, is disclosed in various embodiments. The device features a clearance member in the form of a loop. The loop desirably has a diameter that substantially corresponds to the inner diameter of the medical tube. Also desirably, the loop presents a substantially unobstructed pathway therethrough for the flow of material from a location in the medical tube distal to the loop to a location in the medical tube proximal to the loop regardless whether the clearance member is being translated or is at rest in the medical tube. Methods of utilizing such a device are also disclosed.

Abstract: Various embodiments of an antimicrobial stopcock medical connector is provided. More specifically, the present invention relates to a stopcock tap having fluid channels provided on portions of the outer surface of the stopcock tap, whereby fluid bypasses the stopcock through the fluid channels by flowing between the outer surface of the stopcock tap and the inner surface of the stopcock housing. Some embodiments further comprise an antimicrobial coating or insert that is provided in the one or more fluid channel, whereby fluid flowing through the fluid channels contacts the antimicrobial coating or an antimicrobial agent that is eluted from the antimicrobial coating. Further still, some embodiments of the present invention comprise an antimicrobial groove that is positioned opposite the fluid channel, whereby when the stopcock is in an “off” position, the antimicrobial groove contacts fluid within a blocked port thereby preventing microbial growth therein.

Abstract: A CPAP device includes a flow generator comprising a motorized fan with an outlet. The motorized fan is configured to pressurize a supply of gas. The flow generator further comprises a flow generator outlet in communication with and offset from the motorized fan outlet and comprises a connector configured to receive the pressurized supply of gas from the flow generator, the connector being in communication with the flow generator outlet and positioned downstream of the motorized fan outlet. The connector comprises an attaching portion at a first end, the attaching portion configured to be coupled to the flow generator. The connector also comprises a flexible sealing portion at a second end opposite the first end, the flexible sealing portion comprising a bellows-type conforming face seal that is axially and/or laterally flexible.

Abstract: The present invention relates to a catheter for ventilating a patient, with a ventilation channel for alternately delivering and removing air and/or oxygen to and from the patient's airways, the catheter having a maximum external diameter of at most 6 mm, preferably 2 to 5 mm, and the ventilation channel having an open end, and a connector end for connection to a gas flow reversing element. According to the invention, the catheter is provided with means or elements for measuring the pressure outside the ventilation channel near the open end. The catheter preferably has a pressure measurement channel, with an open measurement end near the open end of the ventilation channel, and a measurement connector piece for connecting a pressure display device. Of particular advantage is a catheter with an expansion body (cuff) that is fluidically connected to a supply channel through which the expansion body can be increased or reduced in size by means of a fluid.

Abstract: A pendant for containing a commemorative or aromatic object includes a first body having inner and outer surfaces, the inner surface being configured to house a second commemorative object or aromatic substance. A second body includes outer and inner surfaces and a plate. The inner surface and plate define a permanently enclosed chamber selectively sealed to retain the commemorative or aromatic object. The second body has an opening with a removable cover for receiving the commemorative or aromatic object in the chamber. A rotatable coupler is provided between the first and second bodies to enable open and closed positions of the pendant. The second body includes a seal formed between the inner surface and the plate to define a portion of the chamber and to define an annular interspace isolating the chamber from an external environment both in the closed and open positions of the pendant.

Abstract: A balloon endoscope including an endoscope body having a selectably pressurizable interior volume, which generally fills the interior of the endoscope body and a selectably inflatable balloon located on an outer surface of the endoscope body and defining a balloon volume which communicates with the interior volume for selectable inflation of the balloon by selectable pressurization of the interior volume.

Abstract: An air-way tube holder includes a face plate having a v-shaped tube-receiving surface that aligns with one side of an opening through the face plate, and a holding block, which is disposed near a second side of the opening. The holding block receives a thumb screw and an engagement arm, the latter including a clamping head, which directly opposes the tube-receiving surface. The thumb screw is adapted to move the clamping head toward the tube-receiving surface to immobilize an airway tube therebetween, either by sliding the thumb screw (gross adjustment) or turning the thumb screw (fine adjustment). The thumb screw/clamping head is releasable by actuating a quick-release mechanism.

Abstract: A portable heating/cooling device for clinical hypo/hyperthermia with cuffs especially designed for arterial cooling/heating for raising or lowering the body temperature of a patient is operable by battery power or a wide range of available external power, and is usable in the field or in medical transport where such external power sources are not available. The small size, weight, and robust nature of the device allows it to be transported with the patient without the need for additional conveying devices.

Abstract: An airway device for human or animal use comprising an airway tube having a distal end and a proximal end, the distal end of which is surrounded by a laryngeal cuff, adapted to fit anatomically over the laryngeal structure of a patient, wherein the device optionally further comprises a buccal cavity stabilizer located on or around the airway tube between the laryngeal cuff and the proximal end of the tube, said buccal cavity stabilizer being adapted to nest with the anterior aspect of the patient's tongue, the size, shape and configuration of the buccal stabilizer being adapted to prevent rotational or side-to-side movement of the airway device in use.

Abstract: A method and apparatus for assessing bodily cavities and lumens utilizing an integrated, automated aerating device is described. The aeration device can selectively supply a gas a liquid during ultrasound and radiographic procedures for enhanced visualization of the uterine cavity and fallopian tubes.

Abstract: A medical mouthpiece may include a U-shaped first member having a tubular portion, the first member forming at least one lateral interocclusal passageway extending through the first member, and a second member received within the tubular portion. A medical breathing apparatus may include a U-shaped first member forming left and right lateral interocclusal passageways extending through the first member, a second member attached to the first member, and an adapter receivable within a tubular portion of the first member, wherein the adapter includes a respiratory orifice configured to deliver respiratory gas to the left and right lateral interocclusal passageways. A method for delivering positive pressure and/or a respiratory gas to a patient may include inserting a mouthpiece into a mouth of the patient, and delivering the positive pressure and/or the respiratory gas through the mouthpiece to a space adjacent a posterior oropharynx of the patient.

Abstract: An endotracheal tube apparatus is provided which comprises an endotracheal tube insertable into a trachea of a patient, wherein the endotracheal tube has a sidewall and includes a first passageway, wherein the first passageway is a ventilation passageway to provide ventilation to the patient; a fluid sampling port connected to the sidewall of the endotracheal tube; the fluid sampling port including a fluid sampling passageway, the fluid sampling passageway to obtain a fluid sample comprising one or more gases exhaled from the patient; and the fluid sampling port including a connector to connect the fluid sampling port to an analyzer to detect a presence of carbon dioxide gas in the fluid sample.

Abstract: A closed suction system module is provided. In one embodiment, the closed suction system module includes a coupling member configured to couple to a suction port of a multi-port manifold or endotracheal tube adapter (e.g., dual-port or tri-port adapter). In one embodiment, the closed suction system module includes a suction catheter configured to clean the interior surfaces of body-inserted tubes or artificial airways (alone or in addition to suctioning natural airways or portions of the respiratory tract or other body lumens). The suction catheter may include a cleaning portion at a distal portion of the suction catheter (e.g., near the distal end or tip of the suction catheter). In some embodiments, the cleaning portion includes at least one expandable cleaning member (e.g., balloon, sleeve, wiper).

Abstract: Various embodiments of an antimicrobial insert for a stopcock medical connector are provided. More specifically, the present invention relates to an antimicrobial insert that is seated within at least a portion of the annular bore of the connector's tap, wherein fluid within the annular bore contacts the antimicrobial insert, thereby preventing microbial proliferation within the stopcock medical connector.

Abstract: A tracheostomy tube apparatus and method includes an outer tube with a first end and a second end and an inside and an outside. Dual inflatable balloons are connected in spiral relation with the outside of the second end of the outer tube. An outer suction tube with more than one outer suction port is connected with the outer tube such that the more than one outer suction port captures secretions from the outside of the outer tube. An inner tube, conformed to fit within the outer tube, is provided. The inner tube has a first end and a second end and an inner suction tube with more than one inner suction port is connected with the inner tube such that the more than one inner suction port captures secretions from the inside of the inner tube.

Abstract: A cannula arrangement includes an inner tube disposed within an outer tube. A flexible sealing element is connected to a proximal portion of the outer tube. The flexible sealing element has a longitudinal axis coaxial with the outer tube. The flexible sealing element has a cantilevered portion that longitudinally extends a longitudinal distance parallel to the longitudinal axis in a proximal direction from the proximal end of the outer tube. The cantilevered portion has a projecting portion that projects diagonally toward the inner tube to define an interior edge to contact an outer surface of the inner tube.

Abstract: The invention relates to an artificial airway device (1) to facilitate lung ventilation of a patient, comprising an airway tube (2) and a mask (3) carried at one end of the airway tube, the mask (3) having a distal end (4) and a proximal end (5) and a peripheral formation (6) capable of forming a seal around the circumference of the laryngeal inlet, the peripheral formation (6) surrounding a hollow interior space or lumen (7) of the (mask (3) and the bore of the airway tube (2) opening into the lumen (7) of the mask, the airway tube including support means (44) such that the cross sectional area of the bore is substantially maintained upon application of pressure by the patient's teeth, while allowing local deformation of the tube at the point of tooth contact.

Abstract: The air freshener consists of a small box formed by coupling together two parts (1, 2) in the form of box halves that can be tightly fitted together, with a perfume-impregnated cellulose block (5) between them. The cellulose block (5) is separated from the bottoms of the boxes and from the side walls by ledges (6) provided on the bottoms of both the female part (1) and the male part (2), and by partitions (7) provided on the male part (2), near the side walls thereof. The box has windows for air inlet (9) and for outlet (8) of the air impregnated with the perfume contained in the cellulose block (5). On the outside of the box there are conformations defining a dovetail joint (10) for securing a clip (11) which, when released from this mounting formed by the conformations (10), can be coupled to an outer recess in the bottom of the male part (2).

Abstract: Systems, devices, and methods are disclosed for the cleaning of an endotracheal tube while a patient is being supported by a ventilator connected to the endotracheal tube for the purpose of increasing the available space for airflow or to prevent the build up of materials that may constrict airflow or be a potential nidus for infection. In one embodiment, a method for cleaning endotracheal tubes comprises inserting a cleaning device within an endotracheal tube while a cleaning member is in a compressed position, radially expanding the cleaning member to an expanded position within the endotracheal tube, and withdrawing the cleaning device from the endotracheal tube with the cleaning member in the expanded position.

Abstract: An airway device configured for intubation under blind or optionally under indirect vision of a fiber optic scope. It also configured to be used as a supraglottic airway device supporting external breathing or anesthesia circuits. The device comprises a tube system with expansion projections, a base, one or more inflation balloons, and a gastric suction tube. The device can include a stylet to guide endotracheal tube during intubation. The tube system can include an air tube and fiber-optic-probe tube. The balloon system can move the end of the tube system anteriorly to align it with the laryngeal opening. The balloon system can seal the airway leakage for low positive pressure ventilation for the device to operate as a supraglottic airway device. The inflation balloon and expansion projection can displace tissue that can block the airway path. The base can carry esophageal gastric drainage tube to the upper esophageal sphincter to block and drain gastric content regurgitation.

Abstract: An aromatherapy device includes a housing forming two annular wells for retaining a scented fluid therein. Each well includes an insert positioned in the well to assist the retention of the fluid in the well by providing a second contact surface for the fluid to contact. The shape of the annular well and the viscosity of the fluid discourage the fluid from leaking out of the housing if laid on its side.

Abstract: Systems, devices, and methods are disclosed for the cleaning of an endotracheal tube while a patient is being supported by a ventilator connected to the endotracheal tube for the purpose of increasing the available space for airflow or to prevent the build up of materials that may constrict airflow or be a potential nidus for infection. In one embodiment, a method for cleaning endotracheal tubes comprises inserting a cleaning device within an endotracheal tube while a cleaning member is in a compressed position, radially expanding the cleaning member to an expanded position within the endotracheal tube, and withdrawing the cleaning device from the endotracheal tube with the cleaning member in the expanded position.

Abstract: Especially during emergencies, there is a need for laryngeal mask heads with a ventral respiration chamber that has a cuff which surrounds the respiration chamber and which can be adjusted in size without having to be inflated. To meet said need, the laryngeal mask head comprises non-pneumatic structures to adjust the size of the mask head in the medial-lateral direction and the ventral-dorsal direction, which are preferably implemented by open, resilient channels extending in the same direction as the cuff.

Abstract: A cuff for an air delivery conduit includes a first end portion provided to a tube and a second end portion adapted to engage a tubular connector. The second end portion includes an entry surface that is curved or chamfered along its length to provide a lead in for inserting the second end portion onto the tubular connector in use. The entry surface provides an internal diameter that is larger than an external diameter of the tubular connector.

Abstract: A CPAP device includes a flow generator including an outlet, a humidifier including an inlet, and an adaptor connector between the outlet of the flow generator and the inlet of the humidifier. The connector includes a flexible and conformable sealing portion that is movable to accommodate misalignment.

Abstract: An airway manifold includes a manifold body having an upper body portion and a lower body portion. The body portions are engaged such that the upper body portion is rotatable relative to the lower body portion, whereby a generally hollow interior space is defined. The lower body portion has a port open to the interior space, and the upper body portion includes a plurality of ports open to the interior space. A first upper body port is axially alignable with the lower body port to define a substantially linear passageway therebetween when the upper body portion is at a first rotatable position relative to the lower body portion. A second upper body port is axially alignable with the lower body port to define a substantially linear passageway therebetween when the upper body portion is at a second rotatable position.

Abstract: A medical mouthpiece may include a generally U-shaped member forming a lateral interocclusal passageway extending from an anterior aperture to a posterior aperture configured to provide a conduit for respiratory gas exchange. A medical mouthpiece may include a sampling port for fluid communication with an analyzing apparatus configured to analyze exhaled respiratory gases. A medical mouthpiece may include a supplemental gas conduit for fluid communication between a source of supplemental gas and a supply orifice. A method for delivering a gas to a patient may include delivering a gas to the patient through a mouthpiece having a lateral interocclusal passageway such that the gas is delivered through a posterior aperture to a space adjacent the patient's posterior oropharynx.

Abstract: A swivel elbow for a mask assembly includes an elbow adapted to be provided to the mask assembly and a swivel detachably connected to the elbow. The elbow includes a plurality of spaced apart rings that provide a controlled clearance between the elbow and an interior surface of the swivel.

Abstract: A laryngeal mask is provided with an outer tube and a connector, having a base end in which is formed a first connecting portion capable of being connected to an artificial respirator and a leading end in which is formed a ventilation opening, the outer tube and the connector having a communication passage formed therein that communicates between the first connecting portion and the ventilation opening, a ring-shaped cuff capable of tightly adhering to a tracheal opening of a patient trachea as a result of inflating in a state where the ring-shaped cuff is inserted to a predetermined insertion position, and hyoid bone-contacting portions and protruding laterally from the outer tube so as to contact from above a site in a pharyngeal portion of the patient corresponding to a hyoid bone of the patient in a state where the ring-shaped cuff is inserted to the insertion position.

Abstract: In an endoscope, a flexible device of an elongated tube has a variable stiffness device. The variable stiffness device includes a movable control wire and a coil spring, to which compression force is applied to change stiffness. There occur changes in stiffness of the flexible device in plural radial directions of the coil spring at an equal point in an axial direction. The variable stiffness device is so constructed that a difference between maximum and minimum levels of stiffness of the variable stiffness device is set at most 0.2 time as much as stiffness of the flexible device with internal structures other than the variable stiffness device. Thus, unexpected grip feeling in manipulation of an operator at the time of advance can be removed in relation to undulating motion of the coil spring.

Abstract: A rescue device for a choking victim and a method of rescuing a choking victim is provided. The device includes a first tube that is configured to be inserted into the victim's mouth so as to assist in dislodging a foreign object in the victim's windpipe by creating a low-pressure environment within the victim's mouth. The device further includes a second tube that is configured to allow a rescuer to create the low-pressure environment in the victim's mouth by sucking on a second tube of the device. A filter is positioned between the first and second tubes to reduce sanitary concerns and to prevent the foreign object from becoming lodged in the rescuer's windpipe.

Abstract: Devices and methods for allowing for improved assisted ventilation of a patient by allowing blind insertion of a device that can allow ventilation regardless of whether the device is positioned within a trachea or an esophagus and allow for timed delivery of ventilations based on a condition of a thoracic cavity to increase the amount and efficiency of blood flow during a resuscitation procedure.

Abstract: The invention includes an alarm assembly configured to engage a tube that is capable of extending into a patient. The alarm assembly comprises alarm circuitry, a wound dressing configured to releasably attach to the patient that includes at least one actuator, and a sensor holder. The sensor holder is configured to be releasably coupled to the tube and includes at least one sensor. The at least one sensor is configured to transmit a signal to the alarm circuitry when the at least one actuator actuates the at least one sensor, and the alarm circuitry is configured to produce an alert in response to receiving the signal. The invention also includes a method of detecting a tube dislodging from a patient, as well as a kit comprising a tube, alarm circuitry, a wound dressing, and a sensor holder.

Abstract: A single lumen endobronchial tube for selective mechanical ventilation of the lungs can include a medical tube having a single lumen with an opening at each of opposed distal and proximal ends of the tube, the opening at the proximal end of the tube being adapted for connection to an external mechanical ventilation device, and the opening at the distal end of the tube being adapted for delivery of a medical gas; a wall extending throughout the tube's entire length having an internal wall surface, an external wall surface and a thickness therebetween, a portion of the wall having an aperture and a shaft adapted to house a mechanism for sealing the aperture; a distal bronchial cuff positioned along the external wall surface and adapted to expand radially outward; and at least a first proximal tracheal cuff positioned along the external wall surface and adapted to expand radially outward.

Abstract: The present invention relates generally to medical devices, methods, and kits. More particularly, the present invention relates to improved endotracheal tubes or patient ventilation tubes which prevent the leakage of proximal secretions to the distal airways.

Abstract: Devices and methods for allowing for improved assisted ventilation of a patient. The methods and devices provide a number of benefits over conventional approaches for assisted ventilation. For example, the methods and devices described herein permit blind insertion of a device that can allow ventilation regardless of whether the device is positioned within a trachea or an esophagus. In addition, the methods and device allow for timed delivery of ventilations based on a condition of a thoracic cavity to increase the amount and efficiency of blood flow during a resuscitation procedure.

Abstract: The invention is directed to a steerable mandrel comprising a stationary part and a movable part. The stationary part comprises a tubular sleeve having a mantle wall with a longitudinal semi-circumferential opening or weakening, which divides the stationary part into a proximal portion located on a proximal side of the longitudinal semi-circumferential opening or weakening and a distal portion located on distal side of the longitudinal semi-circumferential opening or weakening. The movable part comprises a rod-like member, which is slidable within the proximal portion of the stationary part. The movable part is attached to distal portion of the stationary part, such that relative movement of the movable part in relation to the stationary part causes a bending of the mandrel.

Abstract: A guidewire for medical procedures can be maintained in a coiled configuration with a clamp. Multiple clamped and coiled guidewires may be stored in a fluid-filled, storage bowl concurrently. Different clamps may have different colors to differentiate the clamps and clamped guidewires. The clamps may be markable to provide additional differentiation. The clamps can further comprise a guidewire introduction funnel and/or a guidewire torquer.

Abstract: The present invention is a dual lumen endobronchial tube provided with a flexible wall dividing a cylindrical main tube into two lumens, where the outside wall of the main tube is reinforced, preferably by metal wire but alternately by a sufficiently rigid polymer ribbing which will achieve a desired reduction necessary outside wall thickness. The achievement of a reduction in necessary wall thickness enables sufficient hydraulic cross sectional area so that each lumen is capable independently of providing adequate ventilation to a patient even while a ventilation lumen is partly occluded when the insertion end of a bronchoscope or tube is inserted into the adjacent lumen to examine or treat the other lung.

Abstract: An oral airway includes a first component having a first guiding surface and a second component having a second guiding surface. The first component and the second component are adapted to be removably coupled together such that the first guiding surface and the second guiding surface collectively define and encompass an interior passage through the oral airway that is dimensioned to direct, for example, a fiber-optic scope or an endotracheal tube extending through the interior passage for tracheal intubation. The first and second components are configured to be decoupled and independently removed from a patient's mouth without disrupting an endotracheal tube that has been extended through the conduit for tracheal intubation. The first and second components may be maintained in coupled disposition by an interlocking mechanical structure. The first and second components also may be maintained in coupled disposition by magnetism.

Abstract: A laryngoscope insertion section comprising a tube guide including at least an inferior tube guiding member and a superior tube guiding member, wherein the thickness of the insertion section in a first region is less than the external diameter of the largest diameter endotracheal tube in an operating range of endotracheal tube sizes plus the thickness of the inferior tube guiding member plus the thickness of the superior tube guiding member. Typically, the insertion section comprises an elongate member and the tube guide is lateral of the elongate member. Typically, an endotracheal tube is retained within the tube guide in flexural tension.

Abstract: Thus far, it has not been possible to produce laryngeal masks having a supraglottic tube as a one-piece unit. If the supraglottic tube (2) is provided with three lumens (4, 5, 6), the center one (6) of which has no passage to the respiration space (10), a solution is proposed. What is proposed is that the center guide lumen is provided with a longitudinal slit (8) extending from the distal end (9) to the laryngeal mask head (3). A connecting web can be attached between two cores or sliders forming the lumens, generating the desired stability in order to maintain the pressing power tool state without deformation.

Abstract: A harness exterior protection member with an electric wire bundle inserted therein includes a bent portion and a straight portion which are formed in a cylindrical shape in an integrated manner formed of a flame-retardant polyamide resin composition. A thickness of the straight portion is set to be twice to four times of a thickness of the bent portion. A bending radius of the bent portion is 10 mm or larger, and a bending strength of the straight portion is 15 to 25 N.

Abstract: A system is described herein for evacuating gas as it is leaking from a patient's airway. The system comprises a gas evacuation flowpath configured for collecting a gas flow escaping from the patient when inserted into the patient's airway. A vacuum source is connected to the gas evacuation flowpath. Devices that may be employed as part of the system and a method for evacuating gas from a patient are also described.

Abstract: An endotracheal tube comprising a flexible hollow tube with a spiral slit traversing a substantial length of the tube. The slit has edges that separate to create an opening by which the tube may be spiral wound onto a medical device, such as a fiber optic bronchoscope, that is in use in a pharynx passage. The angle of the slit is preferably in the range of 30-60 degrees.

Abstract: A harness exterior protection member with an electric wire bundle inserted therein includes a bent portion and a straight portion which are formed in a cylindrical shape in an integrated manner formed of a flame-retardant polyamide resin composition. A thickness of the straight portion is set to be twice to four times of a thickness of the bent portion. A bending radius of the bent portion is 10 mm or larger, and a bending strength of the straight portion is 15 to 25 N.

Abstract: A tracheal tube apparatus includes a cannula having first and second ends. An inflatable cuff is formed on the cannula between the first and second ends. A conduit extends from the cuff for introducing an inflating fluid into the cuff when it is desired to inflate the cuff and removing inflating fluid from the cuff when it is desired to deflate the cuff. A gauge for indicating the inflation pressure of the cuff is coupled in the conduit.

Abstract: A medical port assembly having a body assembly with a top wall, a bottom wall, first and second walls, and an interior wall. The body assembly further has an exterior wall and an interior adhesive wall. The interior adhesive wall has adhesive means. A permeable wall comprises a slit protected by an overlapping flap. The interior wall and the permeable wall define a cavity. A protective cover covers the interior adhesive wall and/or the cavity. The protective cover adheres to the adhesive. A feeding tube is positioned through the slit. The feeding tube has a distal end, an external retention ring, and at least one port defined as a feeding port, a medication port, or a fluid port. When not utilized, the feeding tube is stored within the cavity.

Abstract: A device for receipt in a user's mouth includes a tongue engagement element having a front region, a rear region, and side regions that define an opening for receiving a user's tongue, means for retaining the user's tongue in a forward position, and means for changing the size of the opening. The tongue engagement element is shaped such that when placed in a user's mouth, the rear region extends over the user's tongue and the front region extends under the user's tongue. A method of securing a tongue engagement element in a user's mouth includes moving an expanded tongue engagement element under a front region of a tongue and over a rear region of the tongue, and allowing the tongue engagement element to return toward a non-expanded state. The tongue engagement element acts to resist rearward motion of the tongue.