Quote from NRSKarenRN
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.
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.