Normally, air moves in and out of tracheostomy tubes (trachs) below the level of the vocal cords rendering a patient aphonic. However, using a Passy Muir valve (PMV), otherwise known as a “speaking valve,” airflow is redirected through the vocal cords during expiration – our standard mechanism of phonation. This one-way valve permits airflow during inspiration but not expiration through its cap. Air exits by passing around the trach tube through the larynx (or if enough pressure builds up in the airway popping off the valve!)
With a PMV, With a PMV, we also re-establish more normal physiology and improve things like oxygenation (closed system permits positive end-expiratory pressure), infection control (no need for finger occlusion of trach to phonate), and olfaction (airflow through the nasal passage). Furthermore, normalizing pressure gradients can help with swallowing and secretion clearance. Just make sure to deflate the cuff before placing the PMV.
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