Subglottic Tubes This is a standard tracheostomy tube with additional subglottic port. Subglottic tube is used to aspirate secretions build up above the cuff on a regular basis of 2-3 hourly and PRN. The tube helps to remove secretions and prevent bacteria build up which mitigates the risk of ventilator-associated pneumonia (VAP).

However, regular measurements of subglottic aspirate, help physicians to determines the effectiveness of swallow and readiness to deflate the cuff for weaning.

Adjustable Flange Trachy Tube Adjustable flange tube can be altered and individualised.

Consideration to use adjustable flange tracheostomy:

• Patients who have deep set tracheas (M:23cm and F:21cm on average)
• Obesity
• Distorted anatomy within the neck/cervical region e.g. oedema, tumours
• Spinal abnormalities e.g. kyphosis (Hunchback) or scoliosis (Twisted spine)

Fenestrated Tube Fenestrated tube: A trach tube with small openings on the superior aspect. The inner cannulas are also fenestrated for this type.

Fenestrated trach tube is used to:

• Supports with weaning of patients/resident
• Increases airflow to upper respiratory tract (URT)
• Can allow enough airflow to support with voice in some cases

NB: Fenestrated tracheostomies can be suctioned but you MUST remove the fenestrated inner cannula for a normal inner cannula.

There may be numerous brands of tracheostomy items used across the UK, BUT the concepts remains the same (Tracoe, shiley).