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1. Review the components to various tracheostomy tubes available and their functions
2. Discuss the decision making process for placement of a tracheostomy tube and the advantages/disadvantages to short- and long-term placement
3. Review basic daily nursing cares necessary for maintaining a tracheostomy
4. Explain the assessment, safety precautions, and utilization of speaking valves
5. Discuss assessment and treatment of swallowing and the application of a speaking valve to minimize aspiration risks and maximize oral communication including bedside screening vs. formal assessment
6. Develop a plan of care and establish professional responsibilities across a multidisciplinary team to manage safe swallowing and maintain verbal communication

• Definition of terminology used
• Surgical vs. Percutaneous Tracheostomy

 

Clinical Features of a tracheostomy tube

 

Intubation and Tracheostomy—Benefits and Risks

• Endotracheal tube advantages/disadvantages
• Tracheostomy tube advantages/disadvantages

 

Sizing tracheostomy tubes

 

Manufacturers of Tracheostomy tubes

 

Special Considerations of managing a tracheostomy tube

• Cuff pressures
• Essential daily cares
  • Necessary supplies
  • Cannula cleaning/exchanging
  • Maintaining stoma and skin integrity
• Minimal Leak technique vs. minimal occlusive volume

 

Speaking Valves

• Anatomy & physiology of common speaking tubes
• Population and timing
• Warning/Precautions
• Assessment and placement guidelines
• Trouble shooting during valve assessment/use

• Ventilator modifications for safety and success
• Inline speaking valves
  • Decision making for the respiratory therapists
  • Tidal volumes
  • Peak inspiratory pressures
  • Minimal vent parameters to facilitate successful application

 

Fenestrated tracheostomy tubes

 

Dysphagia and the tracheotomized patient

• Post extubation consideration
• Effect of tracheostomy on swallowing
• Effect of cervical bracing on tracheotomized patient
• Assessment of swallowing
  • Blue Dye vs. Fees vs. MBSS

• Impact of speaking valve upon swallowing

 

Multidisciplinary care of a patient with tracheostomy

• Role of SLP, nurse, and respiratory therapist
• Review a sample of policy/procedure

 

Case Study 

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**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

Speech-Language Pathologists, Speech-Language Pathology Assistants, Occupational Therapists, Certified Occupational Therapy Assistants Nurse Managers, Nurses, Respiratory Therapists, Rehab Directors, Licensed Practical Nurses