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Humidification to Trach Via Large Volume Nebulizer Or Jet Neb

Humidification to Trach Via Large Volume Nebulizer Or Jet Neb
Laura Castricone, CRT

When someone has a tracheostomy, their nose is bypassed and they are breathing via their tracheostomy. When the nose is not used for breathing, we are depriving our lungs of our natural way to heat, humidify and filter the air we breathe. The most important of these features that the nose usually performs is humidification. Without humidity to our lungs to keep them moisturized, we would not be able to mobilize secretions out of the lungs.

The standard of care in hospitals, rehab centers and home care has been large volume humidification for those who cannot use another form of humidification (ie: HME) without the fear of blocking the airway or clogging the HME with copious secretions (mucus). This set up requires multiple pieces of equipment, both disposable and non-disposable.

Needs for Large Volume Humidification

  • 50 psi compressor
  • Water container (or sometimes referred to jet neb bottle)
  • Corrugated tubing
  • Water traps
  • Trach mask

This way to administer humidity is not portable.

The patient needs to use this system all night long and as many hours during the day that they can. It is necessary to use this often so the airways and more importantly, the lungs, do not dry out.

All disposables need to be changed weekly on this setup to inhibit bacteria and mold growth

The water in the large volume bottle needs to be changed daily and only distilled water should be used.

Pros of Large Volume Humidification

  • Can adjust the amount of aerosol coming from the system to accommodate the patient’s needs
  • Pt will get more moisture from this system, so if they have thick secretions, this is the optimal system for them.

Cons of Large Volume Humidification

  • Uses electricity
  • Not portable
  • Compressor, when running, is loud
  • Multiple parts to assemble
  • Patients report that their clothing gets wet or damp from the aerosol
  • Requires cleaning

Although humidification applied this way may seem archaic, it is still the standard of care for some patients and is quite effective in keeping the airways moisturized. Because water is always a good route for bacteria to grow, it needs to be cleaned often and maintained properly.

All You Need To Know About Tracheostomy


Author Profile: Laura Castricone, Respiratory Therapist

Laura Castricone (Certified Respiratory Therapist)

My name is Laura Castricone and I am a Certified Respiratory Therapist. I have been practicing in the state of Connecticut since 1992. I have worked in several aspects of respiratory care including sleep medicine, critical care, rehab, and home care. I earned my respiratory certification at Quinnipiac University in Hamden, CT. Prior to becoming an RT, I attended the University of Connecticut pursuing a degree in English but left Uconn in my junior year to work with my father in the restaurant business. I stayed with him for over a dozen years. An education, by the way, that can never be bought! Once I married and had children, the restaurant business no longer fit my lifestyle. When my children were one and two years old, I decided to go back to school and that is where my career in respiratory care began. This career has been very rewarding and I have been blessed to meet some extraordinary people along the way. I grew up in Waterbury, CT, and now live in Litchfield County, CT with my husband and our crazy Jack Russell terrier, Hendrix. My hobbies include antiquing, gardening, writing plays, and painting miniature paintings.


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HPFY Laura Castricone, CRT

Laura Castricone, CRT

LinkedIn Profile My name is Laura Castricone and I am a Certified Respiratory Therapist. I have been practicing in the state of Connecticut since 1992. I have worked in several aspects of respiratory ...

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