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Barry I've not had to deal with this particular problem but here are some thoughts. With the suck switch mouthpiece within the mask the user may not be able to disengage from the switch easily. This may well be a problem. Also, I would expect the background pressure to be a cyclically varying pressure, caused by the action of the ventilator, rather than atmospheric pressure which would be the case if the suck switch mouthpiece was open to the atmosphere. The switching threshold may have to be set less sensitive to avoid being triggered by the varying background pressure. The maximum possible duration of suck switch activation may also be limited by the ventilator cycle. We have a patient, with a ventilator via a tracheotomy, who uses a suck/puff switch. In his case the maximum duration is limited to approx. 3 seconds. Hope this helps Colin Geggie Clinical Bioengineer RES Eastern General Hospital Seafield Road Edinburgh EH6 7LN Tel. 0131 536 4695 ***************************************************************** The information contained in this message may be confidential or legally privileged and is intended for the addressee only, If you have received this message in error or there are any problems, please notify the originator immediately. The unauthorised use, disclosure, copying or alteration of this message is strictly forbidden. *****************************************************************