Tracheostomy Education

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In this episode of the Tracheostomy Education Podcast, Nicole DePalma continues the two-part discussion on decannulation with Dr. Jerry Gentile. This episode focuses on what happens after a patient is tolerating capping, how long to monitor before trach removal, the role of FEES in evaluating secretion management and aspiration risk, and what clinicians should know about failed or accidental decannulation. 
Nicole and Jerry discuss the importance of assessing whether the original reason for the tracheostomy has resolved, whether the patient can manage secretions, and whether there is adequate upper airway patency. Nicole explains how Flexible Endoscopic Evaluation of Swallowing, or FEES, can help evaluate secretion management, aspiration, cough strength, sensation, swallowing safety, and airway patency when determining whether a patient is ready for decannulation from a SLP perspective. 
The conversation also covers the transition from capping to trach removal, including monitoring patients for 24 to 72 hours, watching for increased work of breathing, changes in CO₂, oxygen saturation, respiratory rate, coughing ability, and aspiration concerns. Jerry explains what happens after the trach is removed, how the stoma is covered, and why patients may need continued monitoring after decannulation. 
Nicole and Jerry also review failed decannulation, signs that a patient may need recannulation, and the risks associated with accidental decannulation. They discuss when clinicians should call respiratory therapy, why reinserting a trach can be dangerous if not done correctly, and complications such as false tracking and subcutaneous emphysema. 

Topics covered in this episode include:
 The role of FEES in decannulation readiness 
 Secretion management and aspiration risk 
 Airway patency and when to involve ENT 
 Capping trials and 24–72 hour monitoring 
 Oxygen delivery during speaking valve use, capping, and after decannulation 
 Stoma care after trach removal 
 Failed decannulation and signs of respiratory decline 
 Accidental decannulation and when to call respiratory therapy 
 Risks of false tracking and subcutaneous emphysema 
 Pediatric considerations for decannulation
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This episode features Dr. Jerry Gentile and Nicole DePalma discuss the comprehensive process of decannulation for tracheostomy patients. Topics include criteria for safe decannulation, weaning protocols, cuff deflation, downsizing, speaking valves, and special considerations for sleep apnea and obesity. Essential insights for healthcare professionals involved in airway management.
Support the show
https://tracheostomyeducation.com
instagram.com/tracheostomyeducation
linkedin.com/in/nicole-de-palma-708b16b
linkedin.com/in/dr-jerry-gentile

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In this episode of the Tracheostomy Education Podcast, Nicole DePalma, Dr. Jerry Gentile, and guest Gene Gantt discuss the complexities of respiratory care in nursing homes, the importance of accreditation, and the impact of standards of care on patient outcomes. They explore the challenges facilities face in managing costs while ensuring quality care, and how proper implementation of respiratory therapy can lead to significant savings and improved patient health. The conversation emphasizes the need for adequate staffing, training, and the ethical considerations in respiratory care.
Support the show
https://tracheostomyeducation.com
instagram.com/tracheostomyeducation
linkedin.com/in/nicole-de-palma-708b16b
linkedin.com/in/dr-jerry-gentile

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In this episode of the Tracheostomy Education Podcast, Nicole DePalma and Dr. Jerry Gentile speak with Gene Gantt, president of Eventa, about the challenges and innovations in respiratory care for patients with tracheostomy and mechanical ventilation, particularly in long-term settings. They discuss the development of outcomes-based reimbursement models, the issues surrounding weaning patients from ventilators, and the financial incentives that often hinder quality care. The conversation also touches on the competition between nursing homes and long-term acute care hospitals, as well as the often neglected area of tracheostomy care in nursing facilities.
Support the show
https://tracheostomyeducation.com
instagram.com/tracheostomyeducation
linkedin.com/in/nicole-de-palma-708b16b
linkedin.com/in/dr-jerry-gentile

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In this episode of the Tracheostomy Education Podcast, Nicole and Jerry discuss swallowing management for patients with tracheostomy and mechanical ventilation. They explore the increased risk of aspiration, the importance of thorough assessments by speech pathologists, and the use of instrumental assessments like FEES and modified barium swallow studies. The conversation also touches on innovations in swallowing assessment, including subglottic suctioning, and emphasizes the need for individualized care in managing swallowing disorders.
Support the show
https://tracheostomyeducation.com
instagram.com/tracheostomyeducation
linkedin.com/in/nicole-de-palma-708b16b
linkedin.com/in/dr-jerry-gentile