Tracheostomy Decannulation Assessment — FRCA Final MCQ

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EasyIntensive Care MedicineTracheostomy Decannulation AssessmentFRCA Final

A 62-year-old woman in the ICU has a tracheostomy and is being weaned from ventilation. She is asked to cough, swallow water, and phonate with the cuff deflated and a speaking valve in place. This is assessing readiness for:

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Correct answer: D — Tracheostomy decannulation

Assessment for tracheostomy decannulation involves evaluating: (1) ability to maintain a patent airway without the tracheostomy tube, (2) effective cough to clear secretions, (3) safe swallowing (assessed with cuff-down swallow trials), and (4) phonation (indicating air passes around the tube and through the larynx). A structured decannulation protocol (cuff deflation → speaking valve → capping trials → decannulation) is recommended by the NTSP guidelines. Speech and language therapy assessment of swallowing is essential.

Reference: NTSP/DAS/ICS – 2023 – Tracheostomy guidelines; RCOA – 2023 – ICM module