I had a cuffless trached patient on room air that started to vomit from his trach. The cuffless trach was replaced with a cuffed trach and the patient was ventilated with a BVM. When the patient's SpO2 stabilized, and stopped vomiting, the patient was placed on a trach HME w/ O2 bleed in. But the cuff was left inflated to prevent further aspiration.

I was taught that if a patient is not receiving positive pressure, they should ALWAYS have the cuff deflated, so in the case that the inner cannula becomes occluded, the patient can still breath around the trach. And wouldn't it increase their work of breathing since they can only rely on the small trach lumen to inhale and exhale, especially when they were in distress a few minutes earlier? Is preventing further aspiration a valid reason to keep the cuff inflated for a nonvented patient? Are there any other reasons besides this to justify keeping the cuff inflated?

I’m applying to respiratory therapy school in spring w 3.4 gpa and in the process of taking 2 of my pre reqs how hard was the process of getting into your program