lecture 7

Question 1

why do you use trach tubes?

Answer 1

Upper airway obstruction at or above level of vf’s
Potential upper airway obstruction (edema post surgery)
Provision of respiratory care

Question 2

How are they used/implemented?

Answer 2

Tube inserted into trachea via surgical incision b/n 3rd & 4th tracheal ring

Question 3

What different trach tubes are out there?

Answer 3

Outer cannulaA (holds trach site open)
Inner cannulaB (actual breathing tube in trachea)
ObturatorC (smooth tip for initial insertion)
CUFFED
Prevents aspiration
Used w/ ventilators
Inflated for + pressure
CUFFLESS
Aspiration may occur
May interfere w/ laryngeal 
   evelation during swallow
Assists breathing &
   secretion removal
Long-term use
FENESTRATED
Smaller
Used for weaning &
   decannulation
Short-term (3-5 days)

Question 4

signs of aspiration or reflux with tach tube?

Answer 4

Signs of aspiration or reflux:
Food in trach
Endotracheal secretions
—-needs suctioning

Question 5

What are the swallowing txs with trach?

Answer 5

-Pt history (pt symptoms of dysphagia)
-Know type of trach tube and if inflated (cuffed)
-Determine length of time of trach
If 6+ mos trached, scar tissue can restrict laryngeal elevation
-Deflate cuffed tube (w/ medical clearance)
Inflated cuffs irritate tracheal wall during swallow, restricts laryngeal elevation, compresses on esophagus, reduces laryngeal sensitivity
-Suction oral and trach as deflating