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    Tracheostomy Education
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    Category: Tracheostomy Care

    tracheostomy manikin

    Spotlight: Clearview Tracheostomy Simulation Device

    The ClearView Tracheostomy Trainer is an interactive model that addresses the difficulties in tracheostomy comprehension and revolutionizes tracheostomy education. This versatile tracheostomy trainer can demonstrate…

    tracheducation June 12, 2022
    0 Comments

    Flexible endoscopic Evaluation of Swallowing and Tracheostomy

    Flexible endoscopic evaluation of swallowing (FEES) is often performed by speech-language pathologists and is an ideal assessment for patients with tracheostomy and mechanical ventilation.  Patients…

    tracheducation May 16, 2022
    0 Comments
    tracheostomy awareness

    Tracheostomy in the Community

    There are many challenges to caring for a patient with a tracheostomy once discharged to the community, including limited literature on caring for these patients..…

    Tracheostomy Education April 11, 2022
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    Communication Tracheostomy

    ALS and Tracheostomy

    The decision for tracheostomy placement for a person with ALS is personal. Find out information on timing of tracheostomy, swallowing management and …
    tracheducation June 15, 2021
    0 Comments
    trach tips for cleaning

    Tracheostomy Tips from Families and Patients

    Patients and families with tracheostomy live each day with a trach and often become experts in management.  Some patients have provided tracheostomy tips to help…

    tracheducation May 21, 2021
    0 Comments

    Showering and Bathing with Tracheostomy

    Before a patient goes home with a tracheostomy, the patient or care provider should be educated in how to shower or bathe with a tracheostomy…

    tracheducation April 25, 2021
    0 Comments
    tracheostomy simulation lab

    Tracheostomy Simulation Lab

    Each year more and more tracheostomy procedures are performed and in the current setting of Covid-19 we can expect more procedures being performed.  However, clinicians…

    tracheducation January 24, 2021
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    Subglottic sucitoning

    Subglottic Suctioning: Benefits, Covid-19 and Manual versus Automatic

    Subglottic suctioning can significantly reduce secretions above the cuff to reduce the risk of microaspiration and potential aspiration pneumonia. It…
    tracheducation July 22, 2020
    0 Comments
    tracheal stenosis

    Tracheal Stenosis and Intubation or Tracheostomy

    Tracheal stenosis can occur for various reasons and result in a tracheostomy tube. It can also result from the tracheostomy tube procedure or from co…
    Tracheostomy Education July 3, 2020
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    Peg Tube

    Tracheostomy and Feeding Tubes

    Tracheostomy and feeding tubes are often placed concurrently.
    Tracheostomy Education July 1, 2020
    0 Comments
    covid-19 and tracheostomy

    COVID-19 Tracheostomy and Mechanical Ventilation

    The 2019 novel corona virus COVID-19 pandemic has resulted in an increase in patients intubated and use of mechanical ventilation. The United States …
    Tracheostomy Education March 25, 2020
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    cuffed versus cuffless tracheostomy tube

    Cuffed versus Cuffless Tracheostomy Tubes

    Cuffed versus cuffless tracheostomy. Explains the purpose of a cuffed tracheostomy and when to deflate the cuff or switch to a cuffless tracheostomy …
    Tracheostomy Education November 2, 2019
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    Categories

    • Basic Tracheostomy (21)
    • Books (1)
    • Communication options (8)
      • speaking valves (4)
    • Complications of tracheostomy (2)
    • Covid-19 (4)
    • Emergency (2)
    • Infection Control (1)
    • Intubation (1)
    • Laryngectomy (2)
    • Mechanical Ventilation (7)
    • News (3)
    • Patient/Family Journey (3)
    • Pediatrics (10)
    • Swallowing (11)
    • Tools (1)
    • Tracheostomy Care (23)
      • secretion management (9)
    • Tracheostomy tubes (2)
    • Treatment (1)
    • Uncategorized (1)
    Disclaimer. Please Note:

    This information has been collected and designed to help in clinical management, the authors do not accept any responsibility for any harm, loss or damage arising from actions or decisions based on the information contained within this website and associated publications. Ultimate responsibility for the treatment of patients and interpretation of these materials lies with the medical practitioner / user. The opinions expressed are those of the authors. The inclusion in this publication of material relating to a particular product or method does not amount to an endorsement of its value, quality, or the claims made by its manufacturer.

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    Forum Description

    What is a cuffed tracheostomy tube?

    Tracheostomy Tube parts

    A tracheostomy tube may be either "cuffed" or "cuffless (uncuffed)."  A cuffed tracheostomy tubes has a balloon-like feature at the distal end of the tube.  There are three main types of cuffs:  low-pressure cuffs, low-volume cuffs and foam-filled cuffs.  The cuff can be inflated or deflated with air or water depending on which type of cuff is present.  

     

    Patients with COVID-19 with tracheostomy are a high risk for aerosolizing A cuffed tracheostomy tube with the cuff inflated allows for a closed system and is the most likely to prevent cross-contamination of staff, equipment, other patients.

    For more information on patients with COVID-19 and tracheostomy and mechanical ventilation please see our article, COVID-19 Tracheostomy and Mechanical Ventilation.  

    • In Progress tracheostomy care webinar coming soon 14 Lessons

      Adult Tracheostomy Care Webinar: Home Edition

      katrina-cambigue 21% Complete Last activity on April 8, 2022 Coming soon Adult Tracheostomy Care: Home Edition Webinar! 20% off until April 15th!  Adult Tracheostomy Care: Home Edition is a 1 hour recorded webinar which provides information about performing tracheostomy care for adult patients in the home environment. Learn about suctioning, inner cannulas (disposable vs non-disposable), tracheostomy tube cleaning (if indicated), stoma care, cuff management, humidification and communication with the interdisciplinary team.  Videos are used to aide in learner comprehension of tracheostomy care.  A sample interdisciplinary communication form will be provided as well as home care guideline samples. Webinar objectives
      • Identify the indications for and complications of a tracheostomy
      • Note the differences and limitations of tracheostomy care at home versus acute care
      • Demonstrate how to perform trach care (inner cannula changes, site care, cuff management, suctioning)
      • Identify the steps for tracheostomy tube changes
      • Discuss patient/family education for humidification, oxygen, nebulizers, and mechanical ventilation with trachs.
      Instructor:  Katrina Cambigue BS, RCP, RRT-ACCS Katrina is a respiratory therapist at Kaiser Santa Rosa Pulmonary Rehab as well and a clinical instructor at Napa Valley Community College.
    • Start Course Decannulation coming soon 0 Lessons

      Decannulation Webinar: SLP Perspective

      tracheducation 0% Complete 0/0 Steps Coming soon!  Buy now at a 20% discount!! Decannulation Webinar: SLP perspective is an advanced course on determinants of decannulation and importance of the SLP's input for decannulation.  This is a 2.5 hours of material in a recorded webinar.  The course will provide information on FEES to view secretion management to help to determine safety of decannulation.  There will be video cases to show secretion management and information on patient readiness.  Information on cough strength and improving the cough and swallow will be provided to help in the decannulation process.  Cuff deflation, speaking valves and capping will also be described.  The course will also provide a multi-disciplinary decannulation sample protocol. This webinar is a guide to help decannulate patients quicker and safer. It is recommended to take Flexible Endoscopic Evaluation of Swallowing for Patients with Tracheostomy and Mechanical Ventilation prior to this course.   Course presenter: Nicole DePalma, MS CCC-SLP Nicole is the owner of NDoscopy Dysphagia Specialists, a mobile FEES (flexible endoscopic evaluation of swallowing) company servicing New York and New Jersey.  Her areas of expertise include dysphagia management and critically complex patients including tracheostomy and mechanical ventilation in a variety of settings including acute care, long term acute, subacute, and skilled nursing.  She is also a Clinical Consultant for Passy-Muir, Inc. Course Format: Video Powerpoint with author narration and video samples Course Certificate is provided upon completion.
    • Complete Swallow Evaluation for Tracheostomy Course 14 Lessons

      Evidence-Based Swallowing Evaluation for Patients with Tracheostomy and Mechanical Ventilation Webinar

      Nicole 100% Complete Last activity on November 15, 2021

      Swallowing Evaluation for Patients with Tracheostomy and Mechanical Ventilation Course provides in-depth information about how to perform an initial swallow assessment for this patient population.    The course includes effects of tracheostomy on swallowing, research of cuff deflation and how/when to perform cuff deflation, explanation of common mechanical ventilation settings and mechanical ventilation considerations with swallowing, timing of swallow evaluation, Blue Dye testing information, and speaking valves.  Instrumental swallow assessment comparison of modified barium swallow studies (MBS) and flexible endoscopic evaluation of swallowing (FEES) and the advantages and disadvantages.  Ventilator associated-pneumonia factors is also included.  Covid-19 considerations for patients with tracheostomy and mechanical ventilation is also covered.  

      Free access to the Evidenced-Based Swallowing Evaluation Community is also included.  Here, you can ask the instructor any questions in a private forum.  

       

      Course presenter: Nicole M. DePalma, MS CCC-SLP

      Nicole is the owner of NDoscopy Dysphagia Specialists, a mobile FEES (flexible endoscopic evaluation of swallowing) company servicing New York and New Jersey.  Her areas of expertise include dysphagia management and critically complex patients including tracheostomy and mechanical ventilation in a variety of settings including acute care, long term acute, subacute, and skilled nursing.  She is also a Clinical Consultant for Passy-Muir, Inc. 

      Course Format: Video Powerpoint with author narration and video samples

      Course Certificate is provided upon completion. 

    • In Progress tracheostomy care webinar coming soon 14 Lessons

      Adult Tracheostomy Care Webinar: Home Edition

      katrina-cambigue 21% Complete Last activity on April 8, 2022 Coming soon Adult Tracheostomy Care: Home Edition Webinar! 20% off until April 15th!  Adult Tracheostomy Care: Home Edition is a 1 hour recorded webinar which provides information about performing tracheostomy care for adult patients in the home environment. Learn about suctioning, inner cannulas (disposable vs non-disposable), tracheostomy tube cleaning (if indicated), stoma care, cuff management, humidification and communication with the interdisciplinary team.  Videos are used to aide in learner comprehension of tracheostomy care.  A sample interdisciplinary communication form will be provided as well as home care guideline samples. Webinar objectives
      • Identify the indications for and complications of a tracheostomy
      • Note the differences and limitations of tracheostomy care at home versus acute care
      • Demonstrate how to perform trach care (inner cannula changes, site care, cuff management, suctioning)
      • Identify the steps for tracheostomy tube changes
      • Discuss patient/family education for humidification, oxygen, nebulizers, and mechanical ventilation with trachs.
      Instructor:  Katrina Cambigue BS, RCP, RRT-ACCS Katrina is a respiratory therapist at Kaiser Santa Rosa Pulmonary Rehab as well and a clinical instructor at Napa Valley Community College.
    • Start Course Decannulation coming soon 0 Lessons

      Decannulation Webinar: SLP Perspective

      tracheducation 0% Complete 0/0 Steps Coming soon!  Buy now at a 20% discount!! Decannulation Webinar: SLP perspective is an advanced course on determinants of decannulation and importance of the SLP's input for decannulation.  This is a 2.5 hours of material in a recorded webinar.  The course will provide information on FEES to view secretion management to help to determine safety of decannulation.  There will be video cases to show secretion management and information on patient readiness.  Information on cough strength and improving the cough and swallow will be provided to help in the decannulation process.  Cuff deflation, speaking valves and capping will also be described.  The course will also provide a multi-disciplinary decannulation sample protocol. This webinar is a guide to help decannulate patients quicker and safer. It is recommended to take Flexible Endoscopic Evaluation of Swallowing for Patients with Tracheostomy and Mechanical Ventilation prior to this course.   Course presenter: Nicole DePalma, MS CCC-SLP Nicole is the owner of NDoscopy Dysphagia Specialists, a mobile FEES (flexible endoscopic evaluation of swallowing) company servicing New York and New Jersey.  Her areas of expertise include dysphagia management and critically complex patients including tracheostomy and mechanical ventilation in a variety of settings including acute care, long term acute, subacute, and skilled nursing.  She is also a Clinical Consultant for Passy-Muir, Inc. Course Format: Video Powerpoint with author narration and video samples Course Certificate is provided upon completion.
    • Complete Swallow Evaluation for Tracheostomy Course 14 Lessons

      Evidence-Based Swallowing Evaluation for Patients with Tracheostomy and Mechanical Ventilation Webinar

      Nicole 100% Complete Last activity on November 15, 2021

      Swallowing Evaluation for Patients with Tracheostomy and Mechanical Ventilation Course provides in-depth information about how to perform an initial swallow assessment for this patient population.    The course includes effects of tracheostomy on swallowing, research of cuff deflation and how/when to perform cuff deflation, explanation of common mechanical ventilation settings and mechanical ventilation considerations with swallowing, timing of swallow evaluation, Blue Dye testing information, and speaking valves.  Instrumental swallow assessment comparison of modified barium swallow studies (MBS) and flexible endoscopic evaluation of swallowing (FEES) and the advantages and disadvantages.  Ventilator associated-pneumonia factors is also included.  Covid-19 considerations for patients with tracheostomy and mechanical ventilation is also covered.  

      Free access to the Evidenced-Based Swallowing Evaluation Community is also included.  Here, you can ask the instructor any questions in a private forum.  

       

      Course presenter: Nicole M. DePalma, MS CCC-SLP

      Nicole is the owner of NDoscopy Dysphagia Specialists, a mobile FEES (flexible endoscopic evaluation of swallowing) company servicing New York and New Jersey.  Her areas of expertise include dysphagia management and critically complex patients including tracheostomy and mechanical ventilation in a variety of settings including acute care, long term acute, subacute, and skilled nursing.  She is also a Clinical Consultant for Passy-Muir, Inc. 

      Course Format: Video Powerpoint with author narration and video samples

      Course Certificate is provided upon completion. 

    Types of cuffed tracheostomy tubes

    High Volume-low Pressure Cuffs

    Cuffed tracheostomy tube

    Cuffs with a high volume have low-pressure and are called "high volume low-pressure cuffs."  As per manufacturer recommendation,  Bivona Aire-Cuf (Smiths Medical North America, Dublin, Ohio) and Shiley cuffs (Covidien, Mansfield, Massachusetts) should be inflated with air only.

    High volume-low pressure cuffs are generally dual cannula tracheostomy tubes.  Dual cannula tubes have an inner cannula and an outer cannula.  Because of the large volume, a larger surface area is in contact with the tracheal wall, which lowers the incidence of damaging the tracheal mucosa.    However, these cuffs occupy a large amount of space when the cuffs are deflated during ventilator weaning.  The resistance from the cuff may result in difficulty exhaling through the upper airway when the cuff is deflated or difficulty tolerating a speaking valve or cap. 

    cuff deflated tracheostomy
    high volume low-pressure tracheostomy tube with the cuff deflated. Trach mannequin available for purchase in store

    High volume-low pressure cuffs are the most frequently used tracheostomy tube in the US. 

    Low Volume High Pressure Cuffs

    Single Lumen Tracheostomy Tube

    Cuffs with a low volume have a high pressure and are called "low volume high-pressure cuffs."  These are single cannula tracheostomy tubes such as the Bivona Tight to Shaft (TTS).  As per manufacturer recommendations Bivona TTS tracheostomy tubes should be filled with sterile water only.   If filled with air, the cuff will deflate over time due to gas impermeability. 

     Low volume high-pressure cuffs are just as the name describes.  There is a smaller surface area that is in contact with the tracheal wall, resulting in a high pressure seal.  Although the seal may be more effective for positive pressure ventilation to be maintained, there may be a higher risk of tracheal injury.  However, when the cuff is deflated, there is no resistance to airflow through the upper airway and essentially act as a cuffless tracheostomy tube.  

    These may be a good option for patients who are off mechanical ventilation during the day, and on nocturnal ventilation and requiring a cuffed tube.  These patients should have limited secretions if using a TTS tracheostomy tube since there is no inner cannula.  The inner cannula can be removed if there is a blockage from mucous, whereas if the tube does not have an inner cannula and it becomes blocked the entire tube may need to be removed.

    Foam Filled Cuffs

    foam filled cuffed tracheostomy

    Foam filled cuffs are made out of foam mat