cuffed/cuffless trach cannula

cuffed tubes allow positive pressure ventilation and prevent aspiration. if the cuff isn't necessary for those reasons, patients will use a cuffless tube some patients with a cuffed tube will use minimal leak technique for cuff inflation which will still permit speaking and swallowing of secreations.


[color=#153a6b]tracheostomy tubes
http://www.ventusers.org/edu/valnews/val17-4f.html

tracheostomy tubes and related appliances


tracheostomy and speech ---great pics airway and trach devices

Just happened to see this.

NEVER, NEVER keep the cuff inflated with a speaking valve...not even just a little. The cuff MUST be fully deflated before any speaking device is attached such as a Passy Muir Valve.

To do a minimal leak technique, there must be positive pressure ventilation occurring. To patients not on a ventilator, cuff pressures are measured with a manometer. The minimal leak technique (MLT) is done to ensure there is just enough of a seal for proper ventilation on a ventilator. If the patient can still talk, too much leak and volume will be lost.

A cuffed trach can actually promote aspiration if the cuff is ileft nflated during eating and drinking. The patient should have the cuff deflated and a speaking device like the PMV or a cap placed on the trach. The Passy Muir website has excellent continuing education on this. Speech and/or RT should evaluate patient before any speaking valve is initiated for the first time since the tube may be too large for air to move around it especially if it is a cuffed tube. Unless the trach is a TTS (Bivona) with tight to shaft cuff, that deflated cuff will still take up space inside the trachea.

Grey Gull, I should have clarrified referring to ventilated patiens when discussion minimal leak technique. Concur 100% re Passey Muir valve.

also...sometimes a patient will have a cuffed trach for diagnostic testing purposes only..for during the pulmonary appointments. In this case that cuff stays deflated all the time while at home ect.