Monthly Archives: April 2015


First Trach Change

Originally published on November 30, 2011 There is very little research regarding when it is safe to do the first tracheostomy tube change. Commonly, the first tube change is done between post-op day 7-14. A study was just published in Critical Care Medicine and showed that it is safe to do the first tracheostomy change

Complications During Tube Replacement

Originally published on June 23, 2010 C.L. asks, "What are the chances of esophageal or tracheal rupture, or subcutaneous emphysema with reinsertion of a dislodged tracheostomy tube?" Answer: I have never encountered esophageal nor tracheal rupture during reinsertion of a dislodged tube. Nor am I aware of any reports in the literature. Theoretically, it could

Positioning for Trach Reinsertion

Originally published on July 30, 2010 C.L. asks, "If inadvertent decannulation occurs, what is the best patient positioning for reinsertion?" Answer: Supine positioning with neck hyperextension is ideal for reinsertion. However, this may not be appropriate for all patients. The key is visualization of the stoma and adequate lighting. I have reinserted trachs in all