Trach Devices Flashcards
What are 3 types of long term airways?
- Tracheostomy
- Tracheal Stents
- Laryngectomy
What considerations should be taken into account for Permanent Tracheostomies?
Patient education (trach care, suctioning, equipment)
- Equipment
- Trach changes (q3mon)
- Speaking valve
What equipment would be expected to be used with Permanent Tracheostomy’s?
- Humidity - Airvo
- Air compressor/cold nebulizer
- Swedish hnose
What are 2 types of speaking valves?
- Passymuir Valve
- Talking trach
When would talking trachs be used over PassyMuir Valves?
Ventilated patient
How do Tracheostomy Speaking Valves work?
Tracheostomy speaking valves let gas up through the vocal cords for speech
Requirements for a PassyMuir Vave to be used?
Cuff deflation and finger occlusion tolerated
- Pt alert and oriented
- Able to manage secretions and min secretions
- Patent upper airway
Add in quick facts later (slide 5)
What is the most common tracheal stent?
Montgomery tube
- sizes coincide w/shirley trach tubes
- Cap attached to tube
What are indications for a tracheal stent?
Prevent stoma closure if not ready for decannulation
- severe OSA
- Glottic/subglottic stenosis
what is a contraindication that must be met for a tracheal stent to be used?
Pt must have a strong cough w/minimal secretions
What tool can help insert Montgomery tubes?
All is Clamps
- inserted within the tube and pushed in through the stoma site=
What is the proper position for Montgomery Tube?
Space w/C shaped rings should point towards the feet
- tube size number should point towards the head
What is the most common indication for use for Laryngectomy?
Cancer of the larynx
What are traits of Laryngectomy?
Permanent, surgically created stoma between trachea and surface of neck
- Partial or total
- unable to phonate
- Humidity concerns
Can a Laryngectomy use a swedish nose?
- if it can’t what are concerns with that?
need to check later; but if it can’t be used there is a humidity concern
Partial vs Total Laryngectomy?
Determines which section is removed in the neck.
- Partial = Part of a radical neck
- Total = entire removal of voice box
What are the benefits and uses of a Laryngectomy tube?
Maintains stoma patency and can facilitate suctioning
- Can assist in tracheo esophageal puncture speech (blom singer tube and valve)
- Secured w/posey ties
What are speech options for pts w/a Laryngectomy
- Esophageal speech
- Voice prosthesis via tracheo esophageal puncture
- Electro larynx speech
What is Esophageal speech?
Belching, no special equipment needed
How does voice prosthesis bloom singer?
Air exhaled into esophagus via TE puncture
- uses Blom Singer Valve
- Stoma must be occluded to direct air via puncture
How should HME attached via tape or laryngectomy tube be checked?
Visual inspection of blog singer valve w/flashlight
Blom singer valve?
Slide 16
How does a Electro Larnyx Speech device function?
Vibration generated by external electric vibrator
- Placed on cheek or under chin
- How does this device differ from a artificial larynx (slide 18)
How is emergency ventilation performed for a pt with a laryngectomy tube (or similar device)?
- Bag with infant/paediatric mask
- Trach tube
Why might you be unable to ventilate through the upper airway for a patient with a laryngectomy?
Bagger does not attach to laryngectomy tube (no 15mm adapter)
