fenestrated vs unfenestrated canula

[Maria V. Belingon]

i have a patient with a PEG and TRACH....we are asked to ween our patient by making use of the fenestrated and unfenestrated cannula....in order also to train our patient, once or twice in a day we would try to feed him through his mouth ....liquid but with thickener....my question is...IS IT OK FOR US TO FEED OUR PATIENT EVEN IF THE FENESTRATED CANNULA IS USED IN HIS TRACH?

[Alex Egan, LPN, EMT-B]

I don't know the nclex answer to this question. I know once cleared by speech I feed my pediatric patents who have cuffless trachs all the time. If speach says they won't aspirate then that's good enough for the MD to assign a diet. I never understood the logic of inflation of trach cuffs for eating. Seems to me it would make the swallow more difficult. The logic of well if they do aspirate then it won't go into the lungs seems faulty to me. Once the cuff is deflated that aspirate will slowly drip down to the lungs, no way you can suction all of it. Even if it says above the trach you have a giant bacteria colony right by the trach. The key really seems to be not aspirate in the first place.

I will punt and say if the MD says go feed. I would be ok unless the clinical situation I observed was concerning.

[LilyRN99]

I agree.