A 23-year-old patient sustained a cervical spinal cord injury from a motorcycle accident. A tracheostomy is made to facilitate long-term ventilation. In performing tracheostomy care, which of the following is true?
•If the patient is allowed to eat, the cuff should be deflated for meals to reduce the risk of aspiration. It is sometimes thought that an inflated cuff could be related to an increased risk for aspiration, but since aspiration occurs at the level of the vocal folds, any material that reaches the tracheostomy cuff has already been aspirated. In fact, the aspiration rate has been shown to be 2.7 times greater for cuff inflation versus cuff deflation.
•The full length of the tracheostomy tube should be suctioned to remove secretions and ensure a patent airway.
•Dressings are changed every day to prevent infection.
•Tracheostomy ties should not be too tight, this could cause pressure on the jugular veins.