Trach Devices

Question 1

What are 3 types of long term airways?

Answer 1

• Tracheostomy
• Tracheal Stents
• Laryngectomy

Question 2

What considerations should be taken into account for Permanent Tracheostomies?

Answer 2

Patient education (trach care, suctioning, equipment)

• Equipment
• Trach changes (q3mon)
• Speaking valve

Question 3

What equipment would be expected to be used with Permanent Tracheostomy’s?

Answer 3

• Humidity - Airvo
• Air compressor/cold nebulizer
• Swedish hnose

Question 4

What are 2 types of speaking valves?

Answer 4

1. Passymuir Valve
2. Talking trach

Question 5

When would talking trachs be used over PassyMuir Valves?

Answer 5

Ventilated patient

Question 6

How do Tracheostomy Speaking Valves work?

Answer 6

Tracheostomy speaking valves let gas up through the vocal cords for speech

Question 7

Requirements for a PassyMuir Vave to be used?

Answer 7

Cuff deflation and finger occlusion tolerated

• Pt alert and oriented
• Able to manage secretions and min secretions
• Patent upper airway

Question 8

Add in quick facts later (slide 5)

Question 9

What is the most common tracheal stent?

Answer 9

Montgomery tube

• sizes coincide w/shirley trach tubes
• Cap attached to tube

Question 10

What are indications for a tracheal stent?

Answer 10

Prevent stoma closure if not ready for decannulation

• severe OSA
• Glottic/subglottic stenosis

Question 11

what is a contraindication that must be met for a tracheal stent to be used?

Answer 11

Pt must have a strong cough w/minimal secretions

Question 12

What tool can help insert Montgomery tubes?

Answer 12

All is Clamps

• inserted within the tube and pushed in through the stoma site=

Question 13

What is the proper position for Montgomery Tube?

Answer 13

Space w/C shaped rings should point towards the feet

• tube size number should point towards the head

Question 14

What is the most common indication for use for Laryngectomy?

Answer 14

Cancer of the larynx

Question 15

What are traits of Laryngectomy?

Answer 15

Permanent, surgically created stoma between trachea and surface of neck

• Partial or total
• unable to phonate
• Humidity concerns

Question 16

Can a Laryngectomy use a swedish nose?

• if it can’t what are concerns with that?

Answer 16

need to check later; but if it can’t be used there is a humidity concern

Question 17

Partial vs Total Laryngectomy?

Answer 17

Determines which section is removed in the neck.

• Partial = Part of a radical neck
• Total = entire removal of voice box

Question 18

What are the benefits and uses of a Laryngectomy tube?

Answer 18

Maintains stoma patency and can facilitate suctioning

• Can assist in tracheo esophageal puncture speech (blom singer tube and valve)
• Secured w/posey ties

Question 19

What are speech options for pts w/a Laryngectomy

Answer 19

• Esophageal speech
• Voice prosthesis via tracheo esophageal puncture
• Electro larynx speech

Question 20

What is Esophageal speech?

Answer 20

Belching, no special equipment needed

Question 21

How does voice prosthesis bloom singer?

Answer 21

Air exhaled into esophagus via TE puncture

• uses Blom Singer Valve
• Stoma must be occluded to direct air via puncture

Question 22

How should HME attached via tape or laryngectomy tube be checked?

Answer 22

Visual inspection of blog singer valve w/flashlight

Question 23

Blom singer valve?

Answer 23

Slide 16

Question 24

How does a Electro Larnyx Speech device function?

Answer 24

Vibration generated by external electric vibrator

• Placed on cheek or under chin
• How does this device differ from a artificial larynx (slide 18)

Question 25

How is emergency ventilation performed for a pt with a laryngectomy tube (or similar device)?

Answer 25

• Bag with infant/paediatric mask
• Trach tube

Question 26

Why might you be unable to ventilate through the upper airway for a patient with a laryngectomy?

Answer 26

Bagger does not attach to laryngectomy tube (no 15mm adapter)