Many patients who require tracheostomy present with, or are subsequently found to have, swallowing difficulties. This may mean that a degree of malnutrition is present which requires careful assessment and management by the dietetic team.

The multidisciplinary team will be involved in assessment and management as swallowing and nutrition is dependent on many factors.

Dieticians are not only expert in the amount and constituents of nutritional intake, but the best route of delivery.

Question: What are the main types of delivering nutrition to a patient with a tracheostomy?

Answer: Routes of administration may include:

• Simple oral intake (with a full or modified diet consistency)
• Nasogastric or nasojejunal feed
• Percutaneous endoscopic gastrostomy (PEG)
• Intravenous (dedicated parenteral nutrition or glucose-containing solutions)

The return to 'normal' nutrition can be difficult to predict and requires discussion with medical and surgical colleagues and SLTs in order to gauge likely recovery times from the current condition.

Some patients can eat and drink quite normally with a cuff-inflated tube in situ, but for others, the best route for nutrition may require careful assessment over time to find the safest and most effective routes.