Passy-Muir Valve
ITEM NAME
- Passy-Muir Valve
USES
- facilitation of speech in the tracheostomized patient
DESCRIPTION
- valve designed to eliminate the necessity of finger occlusion for the patient with a tracheostomy tube while allowing the patient uninterrupted speech.
- one way valve that allows inspiration via trachy and then during expiration the valve remains closed without leakage.
METHOD OF INSERTION AND/OR USE
- must be awake, responsive and attempting to communicate
- must have appropriate lung mechanics to exhale around the tracheostomy tube
- must be able to tolerate cuff deflation
- must have minimal secretions
- when ready -> place over tracheostomy
CONTRAINDICATIONS
- Unconscious / comatose patient
- Inflated tracheostomy tube cuff
- absent cuff leak when deflated
- Severe upper airway obstruction that may prevent sufficient exhalation
- Excessive secretions
- Severe COPD with gas trapping
- Foam filled cuff tracheostomy tube (eg Bivona)
- Endotracheal tube
OTHER INFORMATION
- doesn’t require a fenestrated tracheostomy
- fits on universal 15mm hub
- oxygen and humidification can be administered via the tracheostomy collar
- can be attached to the tracheostomy ties for ease of attachment and detachment
- can be used in ventilator dependent patients
- reusable, wash in warm soapy water
- can last 2 months
COMPLICATIONS
- anxiety
- airway obstruction if patient is unable to exhale around tracheostomy
- tracheostomy blockage
- strong cough may blow off valve
- WOB may increase
VIDEOS
Anatomy and physiology
Complications of tracheostomy
Cuff deflation and placement of PMV
PMV design
Clinical benefits of PMV
Mechanical ventilation with PMV
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
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