This is very simply a one-way valve which is fitted on to the end of a cuff-down tracheostomy tube, in order to allow speech. This item has its origin detailed, and its virtues extolled, in a comprehensive tribute website which is owned by the manufacturer of the valve.
Anatomy of the item
This thing is a simple one way valve.
One end plugs into the patient's tracheostomy via a standard connector; the other end can plug into a ventilator, or remain open.
Details of function
Having one of these on a tracheostomy enables the wearer to speak. Instead of exhaling through the tracheostomy, the closed valve causes air to travel around the tracheal tube and into the vocal cords.
The fact that the valve remains closed until inspiration begins is helpful, because it keeps a column of air in the trachea, which is under positive pressure while the lungs recoil in expiration. This prevents the aspiration of upper airway secretions and swallowed food or liquids.
Indications for use
- Enabling speech in a tracheostomy patient
- Enabling forceful expectoration of upper airway secretions in a tracheostomy patient
- Decreasing the risk of aspiration in a patient with a cuff-down tracheostomy
This device prevents the need to finger-block one's tracheostomy each time one is inclined to speak or spit.
Contraindications for use
- Inflated (or foam filled) tracheostomy cuff (you wont be able to exhale)
- Absence of a cuff leak with tracheostomy cuff deflated (you wont be able to exhale)
- Thick uncontrolled tracheal secretions (you will clog the valve)
- Thick uncontrolled oral secretions (you need to swallow those, or they will get inhaled)
- Severe respiratory weakness (you will not be able to overcome the valve resistance to inspiration)
- Unconsciousness (You cant deflate the cuff in these people)
- Gas trapping with autoPEEP (the valve will increase PEEP)
Methods of use/insertion
Pretty simple. With the tracheostomy cuff deflated, one attaches the appropriate end of this valve.
The standard connectors make it impossible to reverse the valve (which would have ridiculous consequences)
Complications of use
- The valve may block
- If the upper airway fails, you wont be able to exhale
- A good cough can dislodge the valve, sending it across the room
- Work of breathing may increase
- A small amount of apparatus dead space is added