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1. Review the components to various tracheostomy tubes available and their functions
2. Discuss the decision making process for placement of a tracheostomy tube and the advantages/disadvantages to short- and long-term placement
3. Review basic daily nursing cares necessary for maintaining a tracheostomy
4. Explain the assessment, safety precautions, and utilization of speaking valves
5. Discuss assessment and treatment of swallowing and the application of a speaking valve to minimize aspiration risks and maximize oral communication including bedside screening vs. formal assessment
6. Develop a plan of care and establish professional responsibilities across a multidisciplinary team to manage safe swallowing and maintain verbal communication

ANATOMY AND PHYSIOLOGY OF TRACHEOSTOMY

• Definition of terminology used
• Surgical vs. Percutaneous Tracheostomy

CLINICAL FEATURES OF A TRACHEOSTOMY TUBE INTUBATION AND TRACHEOSTOMY - BENEFITS AND RISKS

• Endotracheal tube advantages/disadvantages
• Tracheostomy tube advantages/disadvantages

SIZING TRACHEOSTOMY TUBES

MANUFACTURERS OF TRACHEOSTOMY TUBES

SPECIAL CONSIDERATIONS OF MANAGING A TRACHEOSTOMY TUBE

• Cuff pressures
• Essential daily cares
  • Necessary supplies
  • Cannula cleaning/exchanging
  • Maintaining stoma and skin integrity
• Minimal Leak technique vs. minimal occlusive volume

SPEAKING VALVES

• Anatomy & physiology of common speaking tubes
• Population and timing
• Warning/Precautions
• Assessment and placement guidelines
• Trouble shooting during valve assessment/use
• Ventilator modifications for safety and success
• Inline speaking valves
  • Decision making for the respiratory therapists
  • Tidal volumes
  • Peak inspiratory pressures
  • Minimal vent parameters to facilitate successful application

FENESTRATED TRACHEOSTOMY TUBES

DYSPHAGIA AND THE TRACHEOTOMIZED PATIENT

• Post extubation consideration
• Effect of tracheostomy on swallowing
• Effect of cervical bracing on tracheotomized patient
• Assessment of swallowing
  • Blue Dye vs. Fees vs. MBSS
• Impact of speaking valve upon swallowing

MULTIDISCIPLINARY CARE OF A PATIENT WITH TRACHEOSTOMY

• Role of SLP, nurse, and respiratory therapist
• Review a sample of policy/procedure

Jerome Quellier, MS, CCC-SLP, is a clinical specialist in traumatic brain injury and communication disorders at a 450+ bed level 1 trauma hospital in Saint Paul, MN with almost 25 years of acute, residential, and outpatient rehabilitation experience. He has focused on neuro-based diagnostics and intervention for dysphagia, cognitive-linguistic deficits, head and neck cancer management, patient advocacy, and curriculum development. Mr. Quellier completed advanced training in brain dissection at Marquette University, actively engages in staff development training, and recently joined a surgery team in preserving language function during tumor resections.

Mr. Quellier is excited to bring this topic to the forefront after working with the interdisciplinary team’s challenges in understanding the "what and why" of traumatic brain injury, stroke, neurodegenerative diseases and tumor resections as they apply to behavioral changes.

Speaker Disclosures:
Financial: Jerome Quellier has an employment relationship with Regions Hospital. He receives a speaking honorarium and recording royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Jerome Quellier is a member of the American Speech-Language and Hearing Association.

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Nurses, Nurse Practitioners, and Clinical Nurse Specialists
This self-study activity consists of 5.75 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, the certificate of completion you receive from this self-study activity and contact your state board or organization to determine specific filing requirements.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 5.5 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 5.5 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 5.9 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

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Occupational Therapists & Occupational Therapy Assistants


Arizona Occupational Therapists & Occupational Therapy Assistants: CE credit is available. This self-study course consists of 5.5 continuing education clock hours for Arizona OTs and OTAs. The Arizona Board of Occupational Therapy Examiners (R4-43-203) confirms acceptance of continuing education programs relevant to occupational therapy that are approved by the American Occupational Therapy Association (AOTA).

Florida Occupational Therapists & Occupational Therapy Assistants: PESI, Inc. is an approved provider with the Florida Board of Occupational Therapy. Provider Number 50-399. This self-study course qualifies for 5.5 continuing education credits.

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Physical Therapists & Physical Therapist Assistants
This self-study course consists of 5.75 clock hours of instruction that is applicable for physical therapists. CE requirements for physical therapists vary by state/jurisdiction. Please retain the certificate of completion that you receive and use as proof of completion when required.

California Physical Therapists & Physical Therapist Assistants: PESI, Inc. is recognized by the Physical Therapy Board of California as an approval agency to approve providers. This self-study lecture qualifies for 5.75 continuing competency hours.

Illinois Physical Therapists & Physical Therapist Assistants: PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270. This self-study course qualifies for 5.5 CE credit hours.

Kentucky Physical Therapists & Physical Therapist Assistants: CE credit is available. This self-study course consists of 5.75 continuing education credit hours for Kentucky Physical Therapists. The rule under 201 KAR 22:045, Section 2, (2)(a) states that category 1 continued competency credits can be earned from providers approved by another physical therapy licensing agency. PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270.

New York Physical Therapists & Physical Therapist Assistants: PESI, Inc. is recognized by the New York State Education Department, State Board for Physical Therapy as an approved provider for physical therapy and physical therapy assistant continuing education. This self-study course qualifies for 7.1 contact hours.

North Carolina Physical Therapists, Physical Therapist Assistants: PESI, Inc. is an approved provider with the Illinois Division of Professional Regulation, Provider Number: 216.000270. This intermediate course is approved by the North Carolina Board of Physical Therapy Examiners by virtue of PESI Inc. approved provider status with the Illinois Division of Professional Regulation. This course qualifies for 5.5 continuing education hours.

Pennsylvania Physical Therapists and Assistants: The Pennsylvania State Board of Physical Therapy recognizes approval by all other state boards. This self-study activity consists of 5.75 clock hours of instruction that is applicable for physical therapists.

Texas Physical Therapists & Physical Therapist Assistants: This self-study activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider #2406032TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas. Instructional level: Intermediate. This activity will provide 5.75 CCUs. The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE. Full attendance is required; no partial credits will be offered for partial attendance.

Utah Physical Therapists and Physical Therapist Assistants: This course is designed to meet the Utah DOPL Rule R156-24b-303b.2.c.iv - A commercial continuing education provider providing a course related to the practice of physical therapy. Please retain a copy of the advertising brochure and your certificate of completion to provide to your board should this be requested of you. This self-study activity consists of 5.75 clock hours of continuing education instruction.

Vermont Physical Therapists & Physical Therapist Assistants: CE credit is available. This course consists of 5.75 continuing education credit hours for Vermont Physical Therapists. The Board confirms acceptance of continuing education programs that are recognized by other state physical therapy licensing boards. PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270.

Virginia Physical Therapists & Physical Therapy Assistants: CE credit is available. This course consists of 5.75 hours of type 2 continued competency credit for Virginia Physical Therapists and Physical Therapy Assistants. Regulation 18VAC112-20-131, Section B, (2) states that up to ten type 2 continued competency credits can be earned by completing independent study activities related to the clinical practice of physical therapy.

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Speech-Language Pathologists & Audiologists
This course contains 5.5 hours of self-study continuing education. It was not offered for ASHA CEUs. Please retain your certificate of completion. If audited for ASHA Certification Maintenance, you can submit this certificate of completion at that time. For state licensure, teacher certification renewal, or other credential renewal, contact those agencies for information about your reporting responsibilities and requirements.

California Speech-Language Pathologists/Audiologists: PESI, Inc. is an approved provider with the California Speech-Language Pathology and Audiology Board, #PDP 319. This course meets the qualifications for 5.5 hours of self-study continuing professional development credit for Speech-Language Pathologists or Audiologists, as required by the California Speech-Language Pathology and Audiology Board.

Florida Board of Speech-Language Pathology and Audiology: PESI, Inc. is an approved provider with the Florida Board of Speech-Language Pathology and Audiology. Provider Number: 50-399. This self-study course qualifies for 5.5 continuing education credits.

Kansas Speech-Language Pathologists: Approved for 7.0 self-study continuing education clock hours for Kansas licensed Speech-Language Pathologists by the Kansas Department for Aging and Disability Services.

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Other Professions
This self-study activity qualifies for 5.75 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

• Speech-Language Pathologists
• Speech-Language Pathology Assistants
• Occupational Therapists
• Certified Occupational Therapy Assistants
• Nurse Managers
• Nurses
• Respiratory Therapists
• Rehab Directors
• Licensed Practical Nurses