bye there are several types of tracheostomy tubes on the left is a cuffless tube this is generally used to provide access to the airway next is a silicon tracheostomy tube it has a balloon or cuff when it's deflated it virtually disappears into the trach tube body next is a standard tracheostomy tube this is most commonly used when a person first receives a tracheostomy in a hospital or an icu the standard trach tube comes with a syringe for the cuff do not inflate or deflate the cuffs unless you're trained by a healthcare provider on the right is a jackson trach made of metal these are the first types of trachs ever used and are still used today the jackson trach is for patients with long-term tracheostomy needs as they can be cleaned and used over again the cuff will only be used for patients on a ventilator or those who have a poor or non-functioning swallow if you have a cuff or balloon you'll need to test its integrity first load your syringe with air and attach it to the pilot balloon slowly inflate the balloon making sure there are no ruptures or tears deflate the balloon before you disconnect the syringe never put a trach cap on a trach tube when the balloon or cuff is inflated the person cannot breathe there are two main types of tracheostomy caps one is a speaking valve and the other is a decannulation cap sometimes referred to as a red cap a speaking valve is a one-way valve that opens when a person breathes in and closes when they breathe out this forces the air over the vocal cords so a person can speak a speaking cap is used when a patient is showing signs of improvement has an effective swallow and is strengthening his breathing muscles the other is a decanulation cap or red cap this cap completely blocks the trach tube and forces the person to use their upper airway to breathe a red cap is used when a person is close to having their trach tube removed and they can breathe on their own using their nose and mouth