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

Develop a Comprehensive Management Plan for Adults Living with Acute & Long-Term Tracheostomy As medical technology and intervention evolves, more patients...
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Information

Faculty:
Jerome Quellier
Duration:
5 Hours 55 Minutes
Format:
Audio and Video
Copyright:
Jun 09, 2018

Description

Develop a Comprehensive Management Plan for Adults Living with Acute & Long-Term Tracheostomy

As medical technology and intervention evolves, more patients are faced with temporary and long-term tracheostomy/ventilation as a part of their recovery. The very presence of a tracheostomy tube may elicit visceral reaction to secretion management and dehumanize the patient who is unable to exercise their decision making capacity, orally communicate their needs, and interact socially with staff or family.

Practitioners in acute hospitals, transitional rehabilitation units, skilled long-term settings, and homecare arenas are challenged to not only understand the basic functionality of a tracheostomy tube, but complete daily cares, assist their patients with swallowing and oral communication, and even train non-medical care providers. Management of the tracheostomized patient is often assumed to be complex. This misconception may become a barrier for placement in an environment most conducive to overall rehabilitation; to foster social closeness with staff, friends and family; and ultimately result in prolonging the weaning process.

This recording will outline and compare the basic components of a tracheostomy tube, decision making surrounding the most appropriate type of tube to use for various populations, and the risks/benefits of placement. Through review of daily cares, the assessment and placement of a speaking valve, and dysphagia characteristics for this population, you will build the skills and confidence necessary to develop a comprehensive management plan. Finish this recording with a solid foundation of general knowledge, critical thinking algorithms, and an understanding of the roles and responsibilities of their specialty when faced with tracheostomized patients.

Handouts

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

Faculty

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

Jerome Quellier, MS, CCC-SLP Related seminars and products: 6


Jerome Quellier, MS, CCC-SLP, is a clinical specialist in traumatic brain injury and communication disorders at a 450+ bed Level 1 Trauma hospital in Saint Paul, MN with almost 25 years of acute, residential, and outpatient rehabilitation experience. During his tenure at the hospital he has focused on neuro-based diagnostics and intervention for dysphagia, cognitive-linguistic deficits, head and neck cancer management, patient advocacy, and curriculum development. Mr. Quellier has made a career-long study of the intricacies of neurology, completed advanced training in brain dissection at Marquette University, actively engages in staff development training, and recently joined a surgery team in preserving language function during tumor resections.

In addition to his clinical practice, he has previously held a faculty position at the University of Minnesota Duluth teaching graduate level coursework, and taught undergraduate workshops as adjunct faculty at the University of Wisconsin Eau Claire. 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 traumatic brain injury, stroke, neurodegenerative diseases and tumor resections as they apply to behavioral changes. He graduated Cum Laude with his bachelor’s degree and graduate degree from the University of Wisconsin Eau Claire.

Speaker Disclosures:

Financial: Jerome Quellier has an employment relationship with Regions Hospital. He receives a speaking honorarium from PESI, Inc.

Non-financial: Jerome Quellier is a member of the American Speech-Language-Hearing Association.