DYSPHAGIA IN THE PATIENT WITH A TRACHEOSTOMY - 6 CASES OF INAPPROPRIATE CUFF DEFLATION OR REMOVAL

Patients with tracheostomy tubes have altered motor and sensory functi ons that may decrease their swallowing efficiency. Failure to recogniz e disorders in deglutition may result in dangerous complications inclu ding aspiration and death. Assessment of dysphagia is especially impor tant in the patient transferred from the intensive care unit to the wa rd-where resources are less abundant. We present six cases in which cu ff deflation or change of tracheostomy tube were undertaken without do cumented swallowing assessment. In these cases each patient was found to be aspirating and required the cuff to be reinflated, or a cuffed t ube to be reinstated when assessed by the multidisciplinary team. Dysp hagia management in the patient with a tracheostomy should be approach ed from a multidisciplinary point of view so that appropriate decision s can be made regarding changes in management and the decannulation pr ocess.