W.C. asks, "I've noticed a small amount of bleeding from my trach recently. Should I be worried?" Answer: The two most frequent causes of tracheal bleeding are due to frequent suctioning and lack of humidity. Regarding frequent suctioning, one should not decrease the frequency of suctioning just because of the appearance of some blood. Rather, this
Dr. C.R. asks, "What kind of home supplies do my tracheostomy patients need?" Answer: Patients need many supplies to manage their tracheostomy. They need plenty of suction catheters, suction machine, tubing, inner cannulas (if disposable), tracheostomy cleaning kits, trach holders, and an extra trach of the same size, and one size smaller. It is essential
Originally published on November 25, 2011 R.H. asks, "We have a tracheostomy patient who is being airlifted to a different facility in another state. Should we have any concerns with air transport?" Answer: The biggest concerns with transport of any kind is dislodgement. So the usual precautions for ensuring tube security should be in place. These include ensuring
Nurse C.D. asks, "What type of emergency equipment should I have at the bedside?" Answer: One must always be prepared for an emergency, and the key is to have essential items always available. These items include: extra tracheostomy tubes of the same size and type, as well as one size smaller, suction catheters (and a
Dr. E.H asks, "What are the most common emergencies with tracheostomies?" Answer: The two most common emergencies with tracheostomies are mucus plugs and inadvertent decannulation/displacement. Mucus plugs occur because of inadequate hydration and inactivity, resulting in thickening and stasis of secretions. Initial presenting symptoms of mucus plugs are respiratory distress and/or desaturation. Treatment involves removing/cleaning
This was a 10-year study done at a tertiary care teaching hospital in Tanzania and included 214 patients. Male to female ratio was 3:1, with a mean age of 38 years. In their study, the most common indication for tracheostomy was upper airway obstruction secondary to trauma or neoplastic causes. Eighty-six percent of tracheostomies were temporary,
Originally posted on January 16, 2012 Decannulation failure is defined as the need to replace the airway after the tube has been decannulated. This Australian study examined 981 ICU patients who received tracheostomies. Seventy-seven percent of them were placed percutaneously and 23% were placed surgically. The mean duration of placement was 16 days. A total of 823 decisions
An Italian study (Clini et al., 2011) followed 77 tracheostomy patients who were determined to be difficult to wean from mechanical ventilation. A physical training program began 48 hours after admission to their regional weaning center. The program consisted of active movement of the limbs, interventions focusing on trunk control, body posture, upper and lower
Because the tracheostomy re-directs air away from the vocal cords, communication may be challenging between patients and their healthcare providers. The following qualitative study was undertaken using a phenomenological approach with patients who were in a rehabilitation environment, had a tracheostomy, and were non-vocal on a ventilator. The sample size consisted of 19 participants, 10