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Discussion

Frequency in changing trach inner cannulas..

Out of curiousity, what is the recommended frequency in changing inner cannulas in traches?

I had a little discussion with someone and she stated that the inner cannula must be changed every shift (12 hours) even when there's barely any mucous or sputum production.

It's this a little over kill?

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Typically I would do q 24, you never gave us what your opinion on this was. How often do you normally do it?

Q12 hrs

  • Experts

In home health, I have seen the orders written for q 8 hrs to q 24 hrs. My opinion is that it could be adjusted for amount of secretions. Once a day is usually sufficient, also more comfortable for the pt.

In my facility we change q24 hrs, but clean q8rs and PRN (depending on the type of cannula).

I hate trachs.:barf01:

  • Author

I change it Q 24hrs. Clean it at least 1-2 times a shift depending on the need. But the person I was talking to said it must be changed with a brand new one Q12 hours no matter what the condition.

I told her the patient had not been coughing out sputum so I did not find the need to change it with a brand new one since it was changed on the previous shift. I did rinse it clean x 1 on my shift which wasn't enough according to her.

Anyway, I would just rather change it with a new one every 12hrs but I also want to help the hospital cut unnecessary costs as well. Depending on the circumstances at hand, if it's unnecessary to change ALL inner cannulas Q12 then I will only clean it as needed. My practice is to change it Q24.

Our facility policy is Q24 hours et then we clean Q shift.

from what I personally have seen/experienced, It depends really on the doctors preference, the type of trach tube, etc..... I have a patient who gets a new canula every 24 hours, they have a portex trach tube. My daughter has a shiley trach tube, and her inner canula is not changed at all...just cleaned as needed hers is the twisting kind that comes with the trach tube .....when she 1st got her trach 10 years ago she had a shiley but it had those clip inner canula that we changed alot........we also changed her trach weekly......now that she has a cuffed trach tube and with insurance rules ($$$$$) she gets a trach change 1x per month...and that's being lucky...most people now get a new trach/canula every 4 months...and that's pushing it.......

check your institution's policies. at our institution, we are to change the inner cannula every 8 hours.

see if you can find the info that came with the trachy kit. It should have the manufacturers recommendations on it somewhere --- in about 20 different languages! :)

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