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This is a discussion on cuffed/cuffless trach cannula in Pulmonary Nursing, part of Nursing Specialties ... To the pulm nurses and resp therapist. I work on a med/surg and step down unit and occasionally I...by Nursebarebari Mar 29, '08To the pulm nurses and resp therapist. I work on a med/surg and step down unit and occasionally I get pts on vent. My question is what is the different b/w cuffed and cuffless trach cannula. Your input would be really appreciated.
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- Mar 31, '08 by NRSKarenRNcuffed 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.
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- Nov 23, '10 by GreyGullQuote from NRSKarenRNJust happened to see this.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.
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.
- Nov 24, '10 by NRSKarenRNGrey Gull, I should have clarrified referring to ventilated patiens when discussion minimal leak technique. Concur 100% re Passey Muir valve.
- May 19, '11 by Sehille4774also...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.