There are two main types of tubes.  Single Lumen and Dual lumen tubes.  Learn about the different types and what makes them unique.

Single Lumen

Bivona TTS with obturator inserted.

The single lumen tracheostomy tube is designed to have only a single lumen.  Bivona is the brand that typically makes only the single lumen tubes.  They have a tight-to-shaft cuff style.

A single lumen tracheostomy tube is good for patients that need mechanical ventilation nocturnally.  During the day the cuff can be deflated and the patient is able to breathe around the tube with less resistance since the cuff lies “tight-to-shaft”.

Dual Lumen

Dual Lumen cannula shown with Inner Cannula (left) and Placement Obturator (right)

Dual Lumen tracheostomy tubes have a main cannula that remains in position.  A removable inner cannula allows for easy cleaning and replacement of a fresh cannula.  The inner cannula can either be reusable or disposable.

The benefit to a dual lumen tracheostomy tube is that daily cares can be accomplished quickly and easily.  Assurance that the inner cannula is clean and the tube is free of obstruction is a valuable trade off to the cost.

One downside of a dual lumen cannula is that the inner cannula reduces the total size of the Inner Diameter (I.D.).  A reduced I.D. can cause increased resistance and work of breathing for the patient.

Understanding the locking mechanisms of differing brands is important.  Some have a 15mm adaptor integrated as part of the inner cannula.  If the inner cannula is removed there is no way to attach a resuscitation bag.  Others are independent of the 15mm adaptor however it is easy to overlook the fact that the inner cannula is removed.

Silver Jackson Trach

The Silver Jackson Tracheostomy tube is a Dual Lumen tracheostomy tube that has been in use since the 1930’s.  It is important to note that this tube does not have a cuff and thus it is used only for the treatment of airway obstruction.  These tracheostomy tubes are still in use however rarely seen.

The Jackson tracheostomy tube is made in adult and pediatric sizes but due to the improvements in the use of plastics there are other tracheostomy tubes that fit a patient’s situation much better.

The inner cannula of the Jackson tube can be removed and cleaned.  Typically this tracheostomy comes with two inner cannulae to facilitate the cleaning and replacement process.

A very important point to note is that the Jackson tube does not have a 15 mm attachment for a resuscitation bag.  A special adapter must be obtained to fit the resuscitation bag onto this tracheostomy tube.

Jackson Trach Adapter – For Resuscitation Bag