If a patient’s condition allows, bedside staff can optimise tracheostomy care to try and maximise airflow via the larynx and allow speech. This usually requires a coordinated multidisciplinary approach with physiotherapy, speech and language therapy, nursing and medical assessment and discussion. Cuff deflation or using an uncuffed tube can help vocalisation but can also increase the breathing effort and cause problems managing oral and respiratory secretions, food or vomit in the throat (increase the aspiration risk). There will also need to be adjustments made to the ventilator if required.
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