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Humidification to Trach Via Large Volume Nebulizer Or Jet Neb

Laura Castricone

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

 

 

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HPFY Laura Castricone

Laura Castricone

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 care including ...

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