Topic: Tests & Procedures
This handout was written to answer some of the questions most often asked about tracheostomy (trach) tube changes. Feel free to ask your doctor or nurse to go over any information you do not understand.
WHAT EQUIPMENT WILL I NEED TO DO TRACH TUBE CHANGES?
• Clean trach tube and obturator
• Velcro trach tube holders
• Water soluble lubricant
• Bag, mask
• Small blanket or towel for neck roll
• Suction Catheter
HOW OFTEN DO I CHANGE THE TRACH TUBE?
The trach tube should be changed once a week, as needed for mucus plugging or as ordered by your doctor.
HOW DO I CHANGE THE TRACH?
• Gather supplies
• Put the obturator in trach. Only the flanges of the trach tube should be touched to ensure the trach tube remains clean
• Cut the trach tube holders to fit
• Attach the holders to the trach
• Lubricate the end of the trach tube with a water soluble lubricant
• Suction and bag the child as needed prior to the change
• Place a blanket or towel roll under the child’s shoulders to hyperextend the neck
• Undo the trach holders
• Remove the old trach following the natural curve of the trach tube
• Insert the new trach tube into the stoma
• Remove the obturator as soon as the trach is in place
• Bag or provide oxygen if needed
• Place child back on vent or trach collar as needed
WHAT DO I DO IF THE TRACH TUBE IS CUFFED?
When setting up the new trach tube, check the cuff by inflating and then deflating it to make sure that it works. The cuff must be deflated when the trach tube is being changed. Inflate the cuff with a syringe of air or saline as ordered by your doctor.
WHAT SHOULD I DO IF I CANNOT GET THE TRACH TUBE IN?
• Hold a gentle steady pressure on the trach tube in the stoma. Once the child takes a breath the trach tube should go in.
• If the tube still does not go in and the child is not in respiratory distress, try to place a trach tube that is a half size smaller.
• If the smaller trach does not go in, do rescue breathing with a mask and bag over the child’s mouth and nose. Cover the stoma site.
• Call for help as needed (911).
HOW DO I CLEAN THE OLD TRACH TUBE FOR RE-USE?
• Wash the trach tube and obturator in a non-oil based dishwashing soap.
• Clean off secretions with a small brush and pass a pipe cleaner through the shaft of the trach tube. (On Bivona tubes the swivel part on top of the tube must be removed to clean it and then put back on when dry).
• Rinse with sterile water.
• Place Shiley trach tube in container with equal parts of hydrogen peroxide and sterile water for 1-2 minutes only (Bivona trach tubes cannot be cleaned in hydrogen peroxide).
• Rinse with sterile water.
• Allow trach tube to air-dry (approximately 20 minutes)
• Place the dry trach tube in a clean container with a lid. Before reusing the trach tube, make sure there are no defects such as cracks or rough edges. Discard any trach tube with defects.
WHEN SHOULD I CALL MY CHILD’S DOCTOR?
Call your child’s doctor if:
• you are having difficulty getting the new trach inserted
• if there is bleeding with the trach change
Call 911 if your child is in respiratory distress.
Derechos de autor(c) de The Children's Medical Center, ano 1999. Este material unicamente tiene fines educativos. No puede ser reproducido, distribuido ni modificado sin previa autorizacion de The Children's Medical Center of Dayton, One Children's Plaza, Dayton, Ohio, 45404-1815. Llame al 937-641-3666 para solicitar autorizacion o para obtener un juego maestro para copias. Para obtener mas informacion puede visitar www.childrensdayton.org (consulte la seccion de informacion legal).
La informacion contenida en este material es unicamente informacion de tipo general. No debe considerarse como completa. Para obtener mas informacion acerca de los complementos para leche materna, por favor pidala a su doctor.
The information contained in this handout is for general information only and should not be considered complete. For specific information about bathing your baby, please ask your doctor or nurse practitioner.
Additional information may be located in the Family Resource Center, 2nd floor, near the Outpatient Surgery Center. Hours of the center vary; please contact the Family Resource Center at 937-641-3700.
Copyright(c) The Children's Medical Center of Dayton. This material is for educational purposes only. It cannot be reproduced or distributed without permission from Dayton Children's.
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