Tracheostomy

COMMON QUESTIONS REGARDING TRACHEOSTOMY

Q: How many inner cannulas do I need in a day?

A: Most people change their inner cannula at least once per day, but if you have copious secretions, you may need to change the inner cannula multiple times a day. Try to gauge for the first month how many inner cannulas you are going through on normal days and use this as a guide.

Q: What happens if I run out of inner cannulas before I get my order?

A: You can clean the one that is currently in your neck to hold you over until you get your shipment. To clean your inner cannula, use a small plastic container that has been washed and rinsed well. Put inner cannula into the container and cover with peroxide. Let soak for aprox. 15 minutes, then rinse well with sterile water, shake off excess and reinsert into your trach tube.

Q: Are trach tubes and inner cannulas sizes interchangeable across manufacturers?

A: No! A Shiley #6 tube is not the same as a Portex #6 tube. The inner cannulas are unique to the manufacturer’s tube so they will not fit another type of tube. If your doctor decides to change the tube in your neck to a different manufacturer’s tube, he/she will know how to make the appropriate adjustments for size.

Q: How can I shower if I have an open trach?

A: There are products on the market that allow you to cover the trach opening to keep water out and without compromising your ability to breathe. Remember, if you are also using oxygen via your trach, you can still administer your oxygen to your trach and shower. Oxygen tubing and standard trach masks can get wet without the fear of damage.

Q: Can I purchase a “speaking valve” like a Passy-Muir valve if I want one?

A: This is an item that requires a doctor’s prescription. The reason a speaking valve may not be appropriate for everyone is because it covers the trach opening and not all can withstand having the opening covered without compromising their breathing. Most trach patients will have “trialed” a speaking valve before it is ordered by the physician.

Q: How do I know the type and size of trach tube I currently have in my neck?

A: On the outside “flange” of the trach tube will be stamped the type and size of the tube. The abbreviations on the flange may not make sense to you, but your provider will know exactly what type you have by the stampings.

Q: Will my trach tube need to be changed?

A: Yes. Your healthcare provider will arrange for you to be seeing an ENT specialist or clinic that caters to this. The tube will most likely be changed periodically for a new tube or a different size tube. This is done in the doctor's office and only takes a few minutes. It is the responsibility of the patient to bring a replacement tube when visiting the doctor for the trach tube change. Most providers will not have any spare tubes in the office.

Q: How much humidity do I need if I have an “open trach”?

A: Guidelines for humidification for an open trach are: all night long while sleeping and as often as possible during the day. If you are able to withstand an “HME” (heat/moisture exchanger), this is a convenient way to keep the airway moisturized. However, like a speaking valve, it covers the trach opening and would require permission from your physician to use.

 

Author Profile: Laura Castricone, Respiratory Therapist

 

 

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