kellyRRT

Cuffs only need to be deflated when you are completely changing the entire trach as in downsizing from say #6 to #4 or trouble with a blown cuff balloon. Routine trach care does not require cuff deflation. PMV was made to be place on the inner cannula.....do NOT remove inner cannula to put on PMV. Some trach plugs (usually red) require removal of inner cannula; but, preferred method is to keep inner cannula in to avoid plugging in entire trach. If mucous clog occurs, inner cannula can be change (if disposable) or cleaned (if NDIC-Non disposable inner cannula). If there is no inner cannula when mucous clog occurs, the entire trach has to be changed.

Trachs are cuffed so patient can be mechanically ventilated. They are NOT cuffed for eating or aspiration prevention purposes. If a patient is able to eat, a cuffless trach is best. PMV valves assist in breathing while eating. PMV valve allows patient to inhale through nose, mouth and trach (cuff MUST be deflated). Exhalation occurs through only the nose or mouth when patient is wearing PMV. Cuffs that are inflated when patient is ingesting whole foods pose a problem swallowing the food down the esophagus. Food must pass by an inflated cuff in the the trachea or windpipe which is directly in front of the esophagus. An inflated cuff, with a patient who is being tubefed or that has GERD can be of assistance in preventing food from aspirating into the lungs; but, preventing aspiration is by NO means the reason why the cuff is there in the first place. Hope you all got A's by now. Hopefully, Respiratory or Speech Therapy will be close by at feeding time to assist with your trached patients!!!!