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Types of Tracheostomy Tubes

A tracheostomy (trach) tube is a curved tube that is inserted into a tracheostomy stoma (the hole made in the neck and windpipe (Trachea)). There are different types of tracheostomy tubes that vary in certain features for different purposes.  These are manufactured by different companies.  However, a specific type of tracheostomy tube will be the same no matter which company manufactures them.

A commonly used tracheostomy tube consists of three parts: outer cannula with flange (neck plate), inner cannula, and an obturator. The outer cannula is the outer tube that holds the tracheostomy open. A neck plate extends from the sides of the outer tube and has holes to attach cloth ties or velcro strap around the neck. The inner cannula fits inside the outer cannula. It has a lock to keep it from being coughed out, and it is removed for cleaning. The obturator is used to insert a tracheostomy tube.  It fits inside the tube to provide a smooth surface that guides the tracheostomy tube when it is being inserted.

There are different types of tracheostomy tubes available and the patient should be given the tube that best suits his/her needs. The frequency of these tube changes will depend on the type of tube and may possibly alter during the winter or summer months. Practitioners should refer to specialist practitioners and/or the manufacturers for advice. 

Tube

Indication

Recommendations

Cuffed Tube with Disposable Inner Cannula

CTDIC

 

 

Click picture  to enlarge

Used to obtain a closed circuit for ventilationCuff should be inflated when using with ventilators. 

Cuff should be inflated just enough to allow minimal airleak.

Cuff should be deflated if patient uses a speaking valve.

Cuff pressure should be checked twice a day.

Inner cannula is disposable.
Cuffed Tube with Reusable Inner Cannula
CTRIC

Click picture  to enlarge

Used to obtain a closed circuit for ventilationCuff should be inflated when using with ventilators. 

Cuff should be inflated just enough to allow minimal airleak.

Cuff should be deflated if patient uses a speaking valve.

Cuff pressure should be checked twice a day.

Inner cannula is not disposable.  You can reuse it after cleaning it thoroughly.
Cuffless Tube with Disposable Inner Cannula
ClessDIC Click picture  to enlargeUsed for patients with tracheal problems
Used for patients who are ready for decannulation
Save the decannulation plug if the patient is close to getting decannulated.

Patient may be able to eat and may be able to talk without a speaking valve.

Inner cannula is disposable.
Cuffed Tube with Reusable Inner Cannula
ClessRIC

Click picture  to enlarge

Used for patients with tracheal problems

Used for patients who are ready for decannulation
Save the decannulation plug if the patient is close to getting decannulated.

Patient may be able to eat and may be able to speak without a speaking valve.

Inner cannula is not disposable. You can reuse it after cleaning it thoroughly.
Fenestrated Cuffed Tracheostomy Tube
FCTT Click picture  to enlargeUsed for patients who are on the ventilator but are not able to tolerate a speaking valve to speakThere is a high risk for granuloma formation at the site of the fenestration (hole).

There is a higher risk for aspirating secretions.

It may be difficult to ventilate the patient adequately.
Fenestrated Cuffless Tracheostomy Tube
FClessTT Click picture  to enlargeUsed for patients who have difficulty using a speaking valveThere is a high risk for granuloma formation at the site of the fenestration (hole).
Metal Tracheostomy Tube
MTT Click picture  to enlargeNot used as frequently anymore.  Many of the patients who received a tracheostomy years ago still choose to continue using the metal tracheostomy tubes.Patients cannot get a MRI.

One needs to notify the security personnel at the airport prior to metal detection screening.

Special Tracheostomy Tubes