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Tracheostomy tubes |
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Cuffed tubes: Used: Immediately after the formation of a Tracheostomy On ventilated patients Unconscious patients When there is a risk of blood and / or secretions entering the airway Patients with no swallow reflex
¨ The cuff is inflated, providing protection of the airway from blood and excess secretions or in ventilated patients, to ensure that gases reach the lungs and not escape through the larynx ¨ The cuff should be of the low pressure, high volume type ¨ This means the cuff pressure is dynamically adjusted at the points of contact within the trachea during the breathing cycle, which minimises the potential for tracheal trauma ¨ Cuff does not need to be periodically deflated, therefore reducing the risk of over-inflation ¨ A Tracheostomy with an inflated cuff reduces the risk of aspirate entering the lungs ¨ Cuff pressure should be checked using a manometer, which should be approximately 25mmHg ¨ Short and long term tubes available, with and without inner cannulae, fenestrated or non-fenestrated
Uncuffed (plain) tubes: ¨ Used when the patient does not need ventilation ¨ Used when no risk of patient aspirating ¨ Used on patients with head and neck tumours ¨ Short and long term tubes available, with and without inner cannulae, fenestrated and non-fenestrated
Fenestrated tubes: ¨ This means a home in the back wall of the tube ¨ They can be on cuffed or uncuffed tubes ¨ They enable air to pass through the patient’s oral/nasal pharynx as well as the tracheal stoma when breathing ¨ This helps patients return to normal breathing ¨ Patients at risk of aspiration should not have a fenestrated tube as it creates an opportunity for the oral and stomach contents to enter the lungs through the fenestrations ¨ An uncuffed fenestrated tube is used when trying to wean patients off a Tracheostomy tube ¨ Patients breathe through the fenestrations of the tube as well as around it ¨ Caution must be used when using a speaking valve and a cuffed fenestrated tube ¨ Decannulation caps should not be used with cuffed fenestrated tubes because the patient will not be able to breathe ¨ Not to be used on unstable head and neck tumours
Inner Cannula: ¨ Should be used with all Tracheostomy tubes at all times ¨ They minimise the chance of the tube becoming blocked by encrusted secretions ¨ Facilitate easy removal of secretions ¨ Prevent unnecessary emergency, or frequent change of full Tracheostomy tube ¨ They are not a substitute for good practices in humidification and suctioning techniques ¨ The inner cannula acts as a ‘safety valve’ in the crust formation inside the tube can be easily removed by taking out the inner tube
Adjustable Flange Tube: ¨ Specifically designed for patients with deep-set tracheas, i.e. obese patients, or those with distorted anatomy due to neck inflammation an oedema ¨ The adjustable flange means the tube can be adjusted to the desired length |
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There are many types of tubes available: |