Originally published on July 23, 2011 B.L. asks, "How does tracheostomy dislodgement happen?" Answer: Dislodgement can be one of the most serious complications of having a tracheostomy. Dislodgement can be even more serious than complete decannulation; because when the tube is completely removed from the stoma (decannulation), the problem is clearly visible. However, when the tube
Originally published on September 13, 2011 P.S. asks, "How do I know that the tube is the correct length?" Answer: It is important to ensure that the tube is neither too short nor too long. If the tube is too short, it can be easily dislodged. If too long, the tube can become "mainstemmed" in the right
Originally published on October 2, 2011 J.D. asks, "I heard that there are many benefits for capping a trach. Can you explain?" Answer: Yes, capping a tracheostomy tube can provide many benefits; the primary benefit is usually allowing a patient to speak. First, not all tracheostomy tubes should be capped. A standard cuffed tracheostomy tube should never
Originally published on January 1, 2011 T.C. asks, "How do wounds around the stoma occur; and when they do, how should they be treated?" Answer: Stomal erosion occurs as a result of either inward or outward traction against the tracheostomy tube. Outward traction is exacerbated with the use of added weight within the ventilator circuit,
Originally published on January 11, 2011 B.R. asks, "What if a patient needs a trach that is shorter or longer than the standard trach, because of his individual anatomy?" Answer: A custom trach can be the answer to meet the needs of patients that cannot be met by any of the standard trachs. Most companies
Originally published on February 2, 2011 T.A. asks, "If a patient uses a cap or a valve in order to speak, should the cuff be inflated or deflated?" Answer: The purpose of the cuff is to seal the airway, and the ability to phonate depends upon air reaching the vocal cords. So the ability to speak
Originally published on March 14, 2011 Family member D.S. asks, "Medicare only supplies one cleaning kit per day, and we were told to clean the trach 2-3 times per day. Is it OK to reuse the cleaning tray and supplies?" Answer: It is very important to clean the trach no less than twice per day while
Originally published on April 26, 2011 B.F. asks, "What is the usual progression of trachs? My mom got her trach after being in the ICU on a ventilator. Now she is off the ventilator...so what happens next?" Answer: The usual progression for tracheostomies depends upon the reason why it was initally placed. For patients who
Originally published on May 21, 2011 Respiratory therapist, S.S., asks, "If the patient has been weaned from the ventilator, should the cuff be inflated or deflated? Answer: The inflated cuff provides a seal of the airway in order to effectively ventilate and oxygenate the patient. When the patient no longer requires the ventilator, it is usually best to deflate
Originally published on June 4, 2011 R.B. asks, "When a patient is on the ventilator, what causes a leak in the cuff?" Answer: There are many causes to a cuff leak. First, to clarify, it is rare that a leak within the cuff actually happens. What happens most often is a leak around the cuff. This leak