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Related Concept Videos

Tracheostomy Care II: Procedure01:25

Tracheostomy Care II: Procedure

Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask and...
Tracheostomy Decannulation01:21

Tracheostomy Decannulation

Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Tracheostomy Suctioning II: Procedure01:23

Tracheostomy Suctioning II: Procedure

Tracheostomy suctioning is a vital nursing procedure that involves removing secretions from the tracheostomy tube to maintain airway patency and prevent respiratory complications. Nurses need to understand the proper technique for tracheostomy suctioning to ensure patient safety and comfort. In this guide, we will outline the step-by-step process for performing tracheostomy suctioning, including preparing the sterile field, donning personal protective equipment (PPE), lubricating and connecting...
Tracheostomy Suctioning I: Pre-Procedural Steps01:26

Tracheostomy Suctioning I: Pre-Procedural Steps

Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...

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Redefining Nursing in Otorhinolaryngology-Head & Neck Care: Implications of the ICN's 2025 Definitions for an Evolving Specialty.

ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses·2026
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Trauma-Informed Care for Voice, Airway, and Swallowing Disorders: A Scoping Review.

ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses·2026
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Standardizing Tracheostomy Discharge Education Using an Interdisciplinary Hand-off Form: A Quality Improvement Study.

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Intrahospital Transport of Adults with Tracheostomy, Laryngectomy, and other Surgical Airways: A Scoping Review of Risks, Processes, and Outcomes.

Tracheostomy (Warrenville, Ill.)·2026
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Advancing Equity in Tracheostomy Care with the Individuals with Disabilities Education Act.

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Related Experiment Video

Updated: Jun 2, 2026

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
07:15

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation

Published on: December 5, 2025

Above Cuff Vocalization for Patients with Tracheostomy: An Evidence Informed, Interprofessional Practice Guidance

Vinciya Pandian1,2,3, Therese K Cole4, Kathryn Mattare5

  • 1Associate Dean for Graduate Education, Ross and Nese College of Nursing, The Pennsylvania State University, University Park, PA.

Tracheostomy (Warrenville, Ill.)
|June 1, 2026
PubMed
Summary

This guidance provides evidence-informed recommendations for above cuff vocalization (ACV) in tracheostomy patients. Standardized ACV practices can improve communication and patient experience while ensuring airway safety.

Keywords:
above cuff vocalizationairway managementclinical practice guidelinecommunication disorderscritical careinterprofessional practicemechanically ventilated patientspatient safetyspeech restorationtracheostomy

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Manufacture of a Multi-Purpose Low-Cost Animal Bench-Model for Teaching Tracheostomy
10:06

Manufacture of a Multi-Purpose Low-Cost Animal Bench-Model for Teaching Tracheostomy

Published on: May 18, 2019

Endotracheal Intubation Using a Flexible Intubation Endoscope as a Standardized Model for Safe Airway Management in Swine
04:30

Endotracheal Intubation Using a Flexible Intubation Endoscope as a Standardized Model for Safe Airway Management in Swine

Published on: August 25, 2022

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Last Updated: Jun 2, 2026

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
07:15

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation

Published on: December 5, 2025

Manufacture of a Multi-Purpose Low-Cost Animal Bench-Model for Teaching Tracheostomy
10:06

Manufacture of a Multi-Purpose Low-Cost Animal Bench-Model for Teaching Tracheostomy

Published on: May 18, 2019

Endotracheal Intubation Using a Flexible Intubation Endoscope as a Standardized Model for Safe Airway Management in Swine
04:30

Endotracheal Intubation Using a Flexible Intubation Endoscope as a Standardized Model for Safe Airway Management in Swine

Published on: August 25, 2022

Area of Science:

  • Medical Practice Guidelines
  • Speech-Language Pathology
  • Respiratory Therapy

Background:

  • Tracheostomy impairs verbal communication, causing patient distress and reduced quality of life.
  • Many patients cannot use traditional voicing methods due to ventilatory dependence or airway instability.
  • Above cuff vocalization (ACV) offers a solution for phonation with a cuffed tracheostomy tube, but its adoption is inconsistent due to safety concerns and lack of standardized guidance.

Purpose of the Study:

  • To develop evidence-informed, interprofessional practice guidance for the safe use of ACV in adults with tracheostomy.
  • Guidance covers initiation, use, monitoring, and discontinuation of ACV.
  • Focus on implementation to support consistent adoption across care settings.

Main Methods:

  • Structured narrative review of peer-reviewed literature on ACV.
  • Incorporation of interprofessional clinical expertise (speech-language pathology, respiratory therapy, nursing, medicine).
  • Development informed by the RIGHT statement, focusing on actionable recommendations rather than formal evidence grading.

Main Results:

  • Recommendations emphasize structured patient selection and speech-language pathology-led initiation.
  • Guidance details low-flow gas titration, time-limited use with observation, and risk mitigation (air trapping, mucosal injury).
  • Outlines interprofessional roles, standardized procedures, monitoring, documentation, and escalation pathways.

Conclusions:

  • This guidance translates ACV literature into actionable recommendations for safe and consistent implementation.
  • Standardized ACV practices can facilitate earlier speech restoration.
  • Adoption may enhance patient communication, experience, and airway safety in selected adults with cuffed tracheostomy tubes.