A home care patient requires intermittent mechanical ventilatory support but is able to eat and speak when off the ventilator. Which of the following tracheostomy tube types is most appropriate for the patient?
A. single-cannula, cuffed
B. bivona foam cuff
C. single-cannula, uncuffed
D. fenestrated
Ans: D. For a home care patient, who does not require positive pressure ventilation constantly, a fenestrated tracheostomy tube will allow the patient to speak when not on the ventilator. A fenestrated tracheostomy tube has an inner cannula that may be removed and a hole in the outer cannula that allows gas to pass through the tube and over the vocal folds, permitting speech.
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