cuffed/cuffless trach cannula

[Nursebarebari]

To 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.

thanks

[NRSKarenRN, BSN, RN]

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

[GreyGull]

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.

[NRSKarenRN, BSN, RN]

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

[Sehille4774]

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.