Choosing the membrane
The FreeHands Starter kit contains three different membranes; light (white), medium (blue), and strong (green). The valve comes with the blue membrane and most patients are found to be comfortable with this membrane. When fitting the FreeHands it is advised to try to speak with the other membranes as well in order to select the optimal membrane for the patient. The white membrane closes at a lower air pressure then the blue membrane and the green one closes at a higher air pressure. During excessive breathing the air pressure might equal the pressure needed for closing the membrane. Therefore, the membrane that might seem optimal for voicing might be less optimal for breathing in some patients. It is advised to check with the patient when exhalation starts to close the valve. Check not only in rest, but also during slight physical activity. When the patient is aware of this, he or she is usually capable of controlling exhalation in order to avoid inadvertent closure of the membrane. For increased exhalation during physical exertion it is advised to use the ‘walk’ position of the device (see walk and talk position). The video clip enlightens this part of the fitting procedure.