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