Tracheostomy tubes may have a cuff. This is a little balloon at the end of the tube which can help to ‘seal off’ the airway. An inflated cuff can reduce the chance of material being inhaled or ‘aspirated’ into the lungs by offering a degree of ‘airway protection.’ The sealed cuff can also allow more effective ventilation to be delivered to the lungs if a patient is attached to a ventilator. However, an inflated cuff can mean that a patient can’t speak, as gas flow doesn’t normally go through the voice box.

We know that getting patients talking is important for lots of obvious reasons, but we think that there may be some additional benefits in getting the larynx working faster, and there are some exciting potential assessments and treatments for patients whose voice box or swallowing isn’t working as it should. Some of these assessments and treatments start by getting the cuff down as soon as we can. This will require careful assessment (and often treatment) of cough effort and effectiveness, oral secretion management and adjustments to ventilation. This needs a coordinated team of physiotherapists, speech and language therapists, nursing and medical staff.

Routine cuff care ensures that the cuff is doing its job, and is explained in this video.

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