Speaking valve
This type of speaking valve has a one-way mechanism where the valve opens on inspiration, allowing air to enter the airway via the tracheostomy, however closes on expiration, forcing air into the upper airway and larynx to allow for phonation.
The following video illustrates how to place a speaking valve:
Watch the video below to find many more benefits of the speaking valve:
Speaking Valves must NEVER be placed on a patient with an inflated cuff as no air will pass to the mouth
Monitoring during a speaking valve trial
Monitor your patient closely for signs of respiratory distress
Any increase work of breathing
Any oxygen desaturation
If the patient is in respiratory distress, remove the valve and reinflate the cuff. Document your findings.
If the patient finds it hard to breathe, or they are unable to vocalise (which they should be able to do) or they begin to sound wheezy or stridulous, then the speaking valve must be removed immediately and the cause of the problem sought.
It is common for some patients to experience some breathlessness when the speaking valve is in place. Reassure your patient and if it does not settle, the speaking valve should be removed immediately.