The cuff on the endotracheal or tracheostomy tube provides airway occlusion. Proper cuff inflation ensures the patient receives the proper ventilator parameters, such as TV and oxygenation. Following hospital policy, inflate the cuff and measure for proper inflation pressure using the minimal leak technique or minimal occlusive volume. These techniques help prevent tracheal irritation and damage caused by high cuff pressure; always practice them with an experienced nurse or respiratory therapist. Never add air to the cuff without using proper technique.

When performing mouth care, suction oral secretions and brush the patient¡¯s teeth, gums, and tongue at least twice a day using
a soft pediatric or adult toothbrush. Use a tonsil suction device if your patient needs more frequent suctioning.

With assistance from an experienced colleague, change the tracheostomy tube or tracheostomy ties and endotracheal tube-securing devices if they become soiled or loose. Incorrect technique could cause accidental extubation.