About Linda L. Morris, Ph.D., APN, CCNS, FCCM

Tracheostomy specialist, Legal consultant and Co-editor/author of Tracheostomies: The Complete Guide, (Morris & Afifi, 2nd Ed. 2021, Chicago: Benchmark Health Publishing)

What is Downsizing?

Originally published on May 30, 2010 P.T. asks, "What is the purpose of downsizing?" Answer: The purpose of downsizing is to allow the patient to do more breathing around the tube, rather than through the tube. When the initial problem that initiated placement of the trach is resolved, downsizing may begin. For example, when the

Discharge Instructions for the Patient with a Tracheostomy

Originally published on December 1, 2010 G.J. asks, "When patients with a tracheostomy are discharged home, what do they need to know to take care of themselves?" Answer: Patients and families who are being discharged with a new tracheostomy need a great deal of teaching in order to become comfortable with their care. Ideally, this

Trach Dislodgement

Originally published on July 23, 2011 B.L. asks, "How does tracheostomy dislodgement happen?" Answer: Dislodgement can be one of the most serious complications of having a tracheostomy.  Dislodgement can be even more serious than complete decannulation; because when the tube is completely removed from the stoma (decannulation), the problem is clearly visible.  However, when the tube

Optimal Tube Length

Originally published on September 13, 2011 P.S. asks, "How do I know that the tube is the correct length?" Answer: It is important to ensure that the tube is neither too short nor too long.  If the tube is too short, it can be easily dislodged.  If too long, the tube can become "mainstemmed" in the right

Capping a Trach

Originally published on October 2, 2011 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

Stomal Wounds

Originally published on January 1, 2011 T.C. asks, "How do wounds around the stoma occur; and when they do, how should they be treated?" Answer: Stomal erosion occurs as a result of either inward or outward traction against the tracheostomy tube. Outward traction is exacerbated with the use of added weight within the ventilator circuit,

Custom Trachs

Originally published on January 11, 2011 B.R. asks, "What if a patient needs a trach that is shorter or longer than the standard trach, because of his individual anatomy?" Answer: A custom trach can be the answer to meet the needs of patients that cannot be met by any of the standard trachs.  Most companies

Dangers with Caps and Speaking Valves

Originally published on February 2, 2011 T.A. asks, "If a patient uses a cap or a valve in order to speak, should the cuff be inflated or deflated?" Answer: The purpose of the cuff is to seal the airway, and the ability to phonate depends upon air reaching the vocal cords.  So the ability to speak

Cleaning Supplies

Originally published on March 14, 2011 Family member D.S. asks, "Medicare only supplies one cleaning kit per day, and we were told to clean the trach 2-3 times per day.  Is it OK to reuse the cleaning tray and supplies?" Answer:  It is very important to clean the trach no less than twice per day while

Trach Progression

Originally published on April 26, 2011 B.F. asks, "What is the usual progression of trachs?  My mom got her trach after being in the ICU on a ventilator.  Now she is off the ventilator...so what happens next?" Answer: The usual progression for tracheostomies depends upon the reason why it was initally placed.  For patients who