J.D. asks, "I heard that there are many benefits for capping a trach. Can you explain?"
Answer: Yes, capping a tracheostomy tube can provide many benefits; the primary benefit is usually allowing a patient to speak. First, not all tracheostomy tubes should be capped. A standard cuffed tracheostomy tube should never be capped, even if the cuff is deflated. When the cuff is deflated, it still provides a great deal of bulk and resistance in the airway. Even if a patient appears to breathe comfortably at one moment, things can change suddenly. In addition, patients may not be able to fully expectorate their secretions, as they may get caught on the folds of the deflated cuff.
Other benefits of capping a tracheostomy tube include restoring subglottic pressure which can in turn restore taste, smell, improve cough and defacation. Another benefit of capping is that the quantity of secretions tends to diminish.
For more discussion on capping, refer to Chapter 5 on phonation and Chapter 11 on downsizing.
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