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Research Article25th Annual New Horizons Symposium: Airway Management: Current Practice and Future Directions

Tracheostomy Decannulation

Heidi H O'Connor and Alexander C White
Respiratory Care August 2010, 55 (8) 1076-1081;
Heidi H O'Connor
Department of Pulmonary and Sleep Medicine, Rose Kalman Research Center, New England Sinai Hospital, Stoughton, Massachusetts.
MD
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  • For correspondence: [email protected]
Alexander C White
Department of Pulmonary and Sleep Medicine, Rose Kalman Research Center, New England Sinai Hospital, Stoughton, Massachusetts.
MD
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    Fig. 1.

    Decannulation assessment.

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    Fig. 2.

    Biased closed position speaking valve. A: Upon inspiration the valve opens and air passes through the speaking valve, down the tracheostomy tube and into the lungs. B: At the end of inspiration the speaking valve returns to a closed position and all exhaled air is redirected through the upper airway, passing through the vocal cords and allowing the patient to speak. (Courtesy of Passy-Muir.)

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    Fig. 3.

    Fiberoptic inspection of the trachea (A) and the subglottic space and vocal cords (B) prior to decannulation.

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    Fig. 4.

    Algorithm for managing unplanned tracheostomy tube dislodgement. (Adapted from illustrations courtesy of Stanley Nasraway MD, Tufts Medical Center, Boston, Massachusetts.)

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    Fig. 5.

    Noninvasive ventilation via nasal pillows with a capped tracheostomy tube. (With patient permission.)

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In this issue

Respiratory Care: 55 (8)
Respiratory Care
Vol. 55, Issue 8
1 Aug 2010
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Tracheostomy Decannulation
Heidi H O'Connor, Alexander C White
Respiratory Care Aug 2010, 55 (8) 1076-1081;

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Tracheostomy Decannulation
Heidi H O'Connor, Alexander C White
Respiratory Care Aug 2010, 55 (8) 1076-1081;
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Keywords

  • mechanical ventilation
  • tracheostomy
  • decannulation
  • speaking valve
  • noninvasive ventilation
  • long-term care hospital

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