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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So today I want to answer another question from one of our members. We have a membership for families of critically ill patients in intensive care that you can find at intensivecarehotline.com and intensivecaresupport.org.

So, let’s read out the question from one of our members who says,

Hi Patrik,

My husband just completed 24 hours on the trach collar this morning. I’m told he still has a lot of secretions so before being evaluated by the speech therapist, they will use a patch which I’m told will be ordered today to keep down the secretions before they use the Passy-Muir valve to assist him to talk and the speech therapist will be back tomorrow. Is this the normal process of things? Thank you so much for your response.

So, when someone starts to talk after having the ventilator removed and now is sitting with a tracheostomy, but no more ventilation, can breathe spontaneously, yes, the next step is often to use a Passy-Muir valve to start talking again.

Now, the challenges are that I’ve seen in over 20 years of working in intensive care as a critical care nurse in three different countries where I also worked as a nurse manager for over five years and having been the founder and director of Intensive Care at Home where we’re looking after ventilation and tracheostomy clients in the community, my experience is yes, that this is the normal course of action.

When someone starts on the Passy-Muir valve, it often mobilizes a lot of secretions because patients are not used to it. They’ve been on the tracheostomy for many weeks, often have been able to talk. So, this is a new sensation for them and therefore, it can be quite upsetting initially for patients.

However, they can often work through it when secretions get mobilized. When a Passy-Muir valve is being used, there’s often a lot of suctioning that needs to happen. A lot of coughing. This is why speech therapy is so important to work with the patients, one on one, with speech therapy. So, they can get retrained to talk again.

So, when the Passy-Muir valve is being placed, usually you should suction before the Passy-Muir valve is placed then the Passy-Muir valve should be washed with warm water. The patient should not wear the Passy-Muir valve while napping or sleeping. So, it’s really something they should only use while they are awake.

Now, more importantly, another thing that needs to happen when the Passy-Muir valve is being used, the cuff needs to be deflated. The tracheostomy cuff needs to be deflated because otherwise the patient can’t speak.

So, then you were also asking about the patch. What patch is being used? Well, there are patches that can be used to minimize secretions or dry up secretions. One of them is a scopolamine patch. And another one is, for example, glycopyrrolate.

The Glycopyrrolate doesn’t come in a patch. It’s usually an IV medication that can be used as well. But there are medications out there to minimize the secretions and they dry up. I’ve talked about this in other videos. But yes, there is a medication out there to reduce the production of saliva. They are classified usually as anti-cholinergic drugs.

So, I hope that helps and answers your question around, should the Passy-Muir valve be being used and what’s the process? And then also after the Passy-Muir valve has been used, the tracheostomy cuff should be reinflated as well.

Now, if you have a loved one in intensive care and you need help and you want to become a member of our membership at intensivecarehotline.com. It’s a membership for families of critically inpatient where we answer all questions, intensive care related 24 hours a day in a membership area and via email, go to intensivecaresupport.org. There, you get access to our membership, and you have access to me and my team 24 hours a day and we answer all questions intensive care related.

Now, I also offer one-on-one consulting and advocacy for families in intensive care. I will talk to you directly. I talk to doctors and nurses directly. I represent you in family meetings and get better outcomes for you making sure that your loved one gets the best care and treatment.

I believe it’s fair to say without any exaggeration that we have saved lives over the years, you can look at our case studies and our testimonials , we have saved many lives in ICU or at least prolonged their lives so that they had a better chance of recovery or also important that families want to have a say in end-of-life situations. They don’t just want to have the one size fits all approach from the ICU team. They want to have a say in how their loved one is going to end their life.

Now we also review medical records in intensive care in real time. So, if you need a second opinion, need a medical record review, we do that as well. Contact us at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to support at intensivecarehotline.com.

Now, we also offer medical record reviews after intensive care if you have unanswered questions, if you need closure or if you are simply if you are simply suspecting medical negligence.

Now, if you find my videos valuable, subscribe to my YouTube channel, click the like button and click the notification bell. Share the video with your friends and families and comment below what you want to see next or what questions and insights you have from this video.

Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com, and I will talk to you in a few days.

Take care for now.

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