Application of the Passy Muir Swallowing and Speaking Valve

Purpose/Goal:

This course covers the basic physiology of upper airway function and identifies the effect of a tracheostomy on physiology and function. It explains how a Passy Muir Valve works and provides step-by-step instructions on the application of the Valve. Some troubleshooting and treatment considerations are discussed, including the review of patient case studies.

Learning Outcomes:

Participants will be able to:

1. Identify the effects of a tracheostomy on upper aero-digestive function
2. Describe the benefits for the use of the bias-closed position no leak tracheostomy and ventilator speaking and swallowing valve
3. Explain the steps for assessing a patient and placing a no-leak speaking valve on a tracheostomy for patient use

Ventilator Application of the Passy Muir Valve

Course Description:

This course reviews the benefits of the Passy Muir Valve, describes assessment, trouble-shooting, and advanced placement techniques, that when implemented in a multi-disciplinary fashion, allow caregivers to successfully place a Passy Muir Valve on adult patients with tracheostomy and mechanical ventilation.

Learning Outcomes:

1. Review the benefits of early intervention and valve use adult and pediatric patients.
2. Identify the different Passy Muir Valves, accessories, and adapters that may be used for in-line ventilator application.
3. List the steps for how to assess baseline mechanical ventilator settings and patient parameters.
4. In case study fashion, describe how to: assess appropriate patients prior to Passy Muir Valve placement; assess proper airway size and patency; and place a Valve correctly in-line with the ventilator circuit.
5. List the principals for: common ventilator adjustments that will maintain adequate ventilation

Facing COVID-19: No Patient with Tracheostomy Left Behind

Course Description:

Part three of our series on COVID-19 addresses the needs of patients with tracheostomies and the healthcare professionals who take care of them. This course will provide an overview of what is known to date about how the coronavirus is impacting patients with tracheostomies and what steps for assessment and treatment should be considered for this high-risk patient population. The patient’s rights and responsibilities when dealing with healthcare matters will be reviewed, including the impact on HIPAA with this new world of crisis care, telehealth, and remote work. This course also will begin a discussion about what the patient population may look like in the future.

Learning Outcomes:

Participants will be able to:

1. Describe special considerations for assessing patients with tracheostomies.
2. Describe patient’s rights and responsibilities with healthcare matters.
3. List steps to consider in the provision of assessment and treatment for patients with tracheostomies.
4. Describe the roles of healthcare practitioners in the face of COVID-19.
5. List criteria for interventions for patients following tracheostomy, including during and after COVID-19.
6. Describe considerations for speaking valve use with patients with COVID-19, including proper handling, use, and cleaning.
7. List three considerations for interventions as impacted by COVID-19, including what changes are occurring with both speech-language pathology and respiratory therapy care.

Airway Management: It’s a Team Sport

Course Description:

Airway management teams have been reported to have an impact on reducing length of stay, decannulation time and preventable adverse events, by providing education and facilitating consistent care and timely decision making. The focus of this presentation will be to provide the HCP with some ideas on how to start an airway management team in their facility, and offer tools to help them keep it going.

Learning Outcomes:

1. Participants will be able to list the benefits of having team management with patients following tracheostomy, including the impact on patient care.
2. Participants will be able to describe the recent research that supports use of an interdisciplinary team.
3. Participants will be able to explain the steps to selecting and implementing a team.
4. Participants will be able to list the potential professions that would make up a team.
5. Participants will be able to describe what is involved in team rounds and what type o follow-up is typically needed by these patients.

Assessing and Treating Dysphagia in the Patient with Tracheostomy: Impacting Quality of Life

Course Description:

It is well-known that the patient with tracheostomy has a high risk of aspiration and associated complications. For this reason, timely, thorough swallowing evaluations are essential. This presentation focuses on evidence-based assessment and treatment strategies to best manage dysphagia in adult patients with tracheostomy.

Learning Outcomes:

Participants will be able to:

1. Explain physiologic changes after tracheostomy that may negatively impact swallowing function.
2. Describe how the Passy Muir Speaking Valve can improve swallowing safety and efficiency.
3. List appropriate swallowing evaluation and treatment techniques for the patient with tracheostomy.

Due to the topic, this course is only approved for ASHA (Speech-Language Pathology) and nursing continuing education credit. This course is not approved for AARC credit.

Assessment for Use of the Passy Muir Valve with the Pediatric Population: Non-Ventilator Use

Course Description:

The course reviewed clinical information regarding indication and timing of tracheostomy in children and its impact on function and development, including communication and oral feeding. Specific assessment and therapy techniques using the Passy-Muir valve, case presentations, and resources were presented.

Objectives:

1. Identify the timing and indications of pediatric tracheostomy.
2. Review the physiological impact of tracheostomy on development and the positive impact of the Passy-Muir Valve.
3. Describe specific evaluation and treatment techniques.

Basic Application of the PMV: An Interactive Discussion

Course Description:

This course began with a review of application of a no-leak valve when a patient is not on a ventilator. Discussion with participants was held in a round table format to allow interaction with the presenter for an elevated question and answer period to clarify and assist with the application principles and techniques encountered in clinical settings and unique to the attendees.

Learning Outcomes:

1. Identify proper assessment and intervention techniques for use of the PMV when the patient is not on a ventilator.
2. Explain the safe and efficacious use of a no-leak Valve with patients for both communication and swallowing.
3. List the parts of a care plan applicable to the clinical setting.

Basic Ventilator Application for the Non-Respiratory Therapist

Course Description:

This course was designed to provide the non-respiratory therapist (RT), such as speech language pathologists and nursing, with a basic understanding of ventilators. It included an overview of terminology for basic understanding of ventilators and better communication with RTs for care of patients. Participants received step-by-step instruction for assessment parameters for inline use of a speaking valve.

Learning Outcomes:

1. Demonstrate understanding of basic ventilator terminology and patient assessment for successful in-line valve use.
2. List the data obtained from the ventilator needed to assess patient candidacy for valve placement.

Due to the topic, this course is only approved for ASHA (Speech-Language Pathology) and nursing continuing education credit. This course is not approved for AARC credit.

Dysphagia Basics following Tracheostomy in the Adult Patient: Considerations for the Non-Speech-language Pathologist (Non-SLP)

Course Description:

Nurses and respiratory therapists may treat patients with compromised health, including a diagnosis of dysphagia. Consequences of dysphagia include malnutrition and dehydration, aspiration pneumonia, prolonged hospitalizations, choking, and even death. This course is intended to provide healthcare professionals, other than speech-language pathologists, with basic information about swallowing and swallowing disorders in adults, including a basic overview of the special considerations for patients with tracheostomies. Topics will include a review of swallowing terminology; normal swallowing; shared systems of breathing and swallowing, including the impact of a tracheostomy; signs and symptoms of aspiration; causes of dysphagia; and highlights of assessment and treatment options. With increased knowledge of normal and disordered swallowing, the healthcare professional may be more equipped to recognize dysphagia in their patients and thus minimize dysphagia related health complications. This course specifically addresses considerations related to respiratory therapy and nursing care.

Objectives:

Participants will be able to:

1. List the stages of normal swallowing.
2. Describe physiologic changes after tracheostomy that may negatively impact swallowing function.
3. Explain how dysphagia is assessed and treated.
4. Explain how the Passy Muir Valve can improve swallowing.

Due to the topic, this course is only approved for AARC (Respiratory Therapy) and nursing continuing education credit. This course is not approved for ASHA credit.

Pediatric Application of the Passy Muir Valve: Considerations with Mechanical Ventilation

Course Description:

This course covered assessment, trouble-shooting, and advanced placement techniques for successful use of a Passy-Muir Valve with pediatric patients on mechanical ventilation. A review of cuffed/cuffless trachs, pressure ventilation, and pediatric circuit connections were included. Pediatric case studies enhanced learning of concepts.

Objectives:

1. Review the benefits of early intervention and Passy-Muir Valve use with pediatric patients on the mechanical ventilation.
2. Identify the Passy-Muir valves, accessories, and adaptors that are typically used for pediatric circuit connections.
3. Describe how to assess pediatric baseline mechanical ventilator settings and patient parameters.
4. Describe how to assess proper airway size and patency; and how to place a Valve in-line with the ventilator circuit.
5. List the principals for common ventilator adjustments (during both volume and pressure ventilation) that will maintain adequate ventilation in the absence of a cuff.
6. Explain the importance of appropriate alarm settings to promote safe use of the Passy-Muir valve, as well as other ventilator mode options that enhance successful use of the in-line valve.

Ventilator Application of the No-leak Valve: An Interactive Discussion

Course Description:

This course is intended to provide respiratory therapists, and other members of the mechanically ventilated patient care team, with the primary operational principles of application of a no-leak valve placed in the circuit of a mechanical ventilator. Specific technical aspects of ventilator placement and operation will be provided, followed by an open discussion which will allow participants to interact with the presenter in order to answer questions and clarify the techniques and principles discussed. The interactive aspect of this course is intended to assist the participant in applying the principles and techniques discussed to the clinical setting unique to each attendee.

Objectives:

1. The participant will be able to identify primary goals for use of a no-leak Valve during mechanical ventilator support.
2. The participant will be able to explain the operational principles determining safe and effective ventilator accommodations during no-leak Valve use with mechanical ventilation.
3. The participant will be able to develop a care plan for application of a no-leak Valve with the mechanical ventilator applicable to their own clinical setting.

Clinical Round Table: Answering Questions Related to Speaking Valve Use

Course Description:

This webinar provided an interactive, round table format during which the host clinical specialists answered clinical questions posed by the audience, related to working with patients following tracheostomies. The panel demonstrated multidisciplinary communication through a question-and-answer format, asking respiratory therapy and speech-language pathology-specific questions to each other.

Learning Outcomes:

1. Describe the impact of tracheostomies on physiology and what steps may be taken to improve airway patency.
2. List concepts related to troubleshooting speaking valve use.
3. Answer questions related to evidence-based care of patients with tracheostomies.

Puzzle-solving: What are the parts and pieces to Valve placement?

Course Description:

This webinar reviewed the parts of a tracheostomy tube, including proper identification of tracheostomy tube size, cannulas, and cuffs. It included the types of Passy-Muir Valves, their differences, and how to place them on a tracheostomy tube hub. Valve accessories and how to use them for proper inline placement of the Valve with mechanical ventilation were demonstrated.

Learning Outcomes:

1. Label the parts of a tracheostomy tube, including size and other specifications.
2. List similarities and differences between the PMVs, including proper selection for patient use.
3. Describe what accessories are used to place a Valve inline with mechanical ventilation, including the appropriate sequence and how to place them.

Trachlore: Misconceptions, Misinformation, and Myths

Course Description:

This course examined the common misconceptions about tracheotomy and the care related to cuff management. Discussion about changes in physiology that may follow placement of a tracheostomy tube and inflated cuff was reviewed. Using evidence-based literature, this course provided information for better decision-making when caring for a patient with tracheostomy.

Learning Outcomes:

1. Discuss the changes in airway physiology following tracheostomy tube placement.
2. List common misconceptions about tracheostomies and speaking valves.
3. Describe the truth behind the myths to improve care of patients with tracheostomies.

Only the Basics: Introduction to Tracheostomy Tubes and No-leak Speaking Valves

Course Description:

This introductory course is designed to teach students and novice clinicians basic information about tracheostomy and no-leak speaking valves. The presentation will review changes in upper airway physiology after tracheostomy and will describe indications, benefits, and components of tracheostomy tubes. The design of a no-leak speaking valves and the essential elements for placing it will be presented. Demonstrations of cuff inflation and deflation and Valve placement and removal will be provided to enhance learning.

Learning Outcomes:

1. Describe the components of various tracheostomy tubes as they related to airway patency.
2. Detail changes in upper airway physiology after tracheotomy.
3. Explain the design and benefits of the no-leak speaking valve.
4. Describe essential elements of Valve placement and use.

Recognizing the Differences: Tracheostomy Tubes and Cuff Types

Course Description:

This course is intended to provide clinical professionals with the ability to recognize tracheostomy tubes and cuff differences for pediatrics and adults. Different brands and styles of tracheostomy tubes will be reviewed to provide insight regarding tube selection, proper sizing considerations, and components of the tubes. This course will show the various types of tracheostomy tube cuffs, discussing some of the reasons why certain cuffs or cuffless tracheostomy tubes may be used. Following this course, the participant will know where to find information on trach brand, size, and type when working with a patient following a tracheostomy.

Learning Outcomes:

1. Identify and label different brands of tracheostomy tubes.
2. Identify adult, pediatric, and neonate tracheostomy tubes.
3. Identify the components of a tracheostomy tube.
4. Describe the differences between a cuffed and cuffless tracheostomy tube.
5. List specialty tracheostomy tubes.