speaking valve for trachs

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Specializes in LTC.

Has anyone ever herd of a speaking valve being surgicaly implanted in a vent patient I was ask this question by a patient of mine and I told him I would check into it for him

thanks

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Specializes in neuro, ICU/CCU, tropical medicine.

It's called a Passy Muir valve, and it just fits on to the opening of the trach - any respiratory therapist should be able to help you out with that - in fact, you'll need an RT ro assess whether the patient can tolerate a PM valve.

Good luck!

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I don't think the Passy Muir valve will work on a ventilated pt, and plus it's not surgically implanted. It's been a while since I've seen one, and it was on a trach pt (weaned off the vent) and it just screwed on.

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Specializes in Peds (previous psyc/SA briefly).

A fenestrated trach tubes and a trach button that doesn't extend into the airway both allow speech... but I dont know if either would be a good bet with a vent.

I've personally never seen a talking trach... not common in our population. But they are out there.

There are at least 3 different kinds of valves that come on and off....

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Specializes in neuro, ICU/CCU, tropical medicine.
I don't think the Passy Muir valve will work on a ventilated pt, and plus it's not surgically implanted. It's been a while since I've seen one, and it was on a trach pt (weaned off the vent) and it just screwed on.

I thought about that after I posted, but I knew that someone would pick up on it - thanks.

Several years ago I heard Christopher Reeve address the Society for Neurosciences. He was a C2, vent-dependent quad. It was interesting hearing him speak, because it sounded like he wasn't timing his speech to the ventilator cycle - in other words, it sounded like air passed over his vocal cords both during inspiration and expiration, but I could be wrong.

Anyway, he's not the first vent-dependent quad with a trach I've heard speak. Come to think of it, I think it's usually just a fenestrated trach that allows them to talk, but it's been a while since I've worked with quads.

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Specializes in LTC.

thank you, he does already use the valve and can speak with it the only problem is that after awhile he has to have it taken out to regain his 02 level i do appreciate you responding to my question

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Specializes in Homecare Peds, ICU, Trauma, CVICU.

I work with many pediatric vent dependent clients and the PMV is introduced as soon as possible. It is actually beneficial because it does help to increase lung pressures and does help assist with vent weaning in those that are able to be weaned. It also dramatically decreases the need for suctioning. Most of these babies' vents are on SIMV mode with lower breath rate settings from 10-18 so the interference with vocalizing is minimal. Sometimes it can be a long slow process with many short trials until they're able to tolerate the PMV for longer periods. They're usually able to tolerate 24 hrs/day eventually (except those that are prevented from using it d/t tracheomalacia, etc) Oh, and I've yet to see them use a fenestrated tube. Not really sure why.

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Specializes in PACU.

The Passey-Muir Valve CAN be used by mechanically-ventilated patients. It is placed at the end of the circuit before the connector that attaches the circuit to the trach tube. In acts as a one-way valve making it so that the ventilator's delivered breaths enter, then the patient can control the exhalation somewhat, meaning he can talk independent of the cycle of the ventilator.

I am not aware of any surgically implanted equivalents and believe it would be imprudent to do that when the external valve is an option. If the upper airway were to become filled with secretions or otherwise obstructed an internal device would prevent exhalation and would be difficult to remove.

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