Caring For Patients with Tracheostomy & Ventilator Dependency: A Practitioner’s Guide to Managing Communication and Swallowing

Credit

Speaker

Jerome Quellier, MS, CCC-SLP Related seminars and products

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Mr. Quellier is a retired clinical specialist in traumatic brain injury and communication disorders from a 450+ bed level 1 trauma hospital in Saint Paul, MN with over 28 years of acute, residential, and outpatient rehabilitation experience. Throughout his career, he focused on neuro-based diagnostics and intervention for dysphagia, cognitive-linguistic deficits, head and neck cancer management, patient advocacy, and curriculum development. Mr. Quellier completed advanced training in brain dissection at Marquette University, actively engaged in curriculum creation and staff development training, and collaborated with a neurosurgery team in preserving language function during tumor resections.

Mr. Quellier is excited to bring this topic to the forefront after working with the interdisciplinary team’s challenges in understanding the “what and why” of aberrant cognitive control that places patients at heighten dysphagia risk.

 

Speaker Disclosures:
Financial: Jerome Quellier receives a speaking honorarium and recording royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Jerome Quellier is a member of the American Speech-Language and Hearing Association.

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Objectives

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

Outline

ANATOMY AND PHYSIOLOGY OF TRACHEOSTOMY

• 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

Target Audience

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