[happylush]

Hey everyone! I posted this in the pulmonary section but wanted to know what you all think....

[happylush]

Hey everyone. I have a question. When you have a patient that has a cuffed trach, are you supposed to deflate the cuff before removing the inner cannula or not, and what is the purpose of it? Trach's still confuse me and scare me little bit..... I see everyone doing things different ways in the hospital and want to now what is the right way? Do the cuffs just help prevent aspiration? Sorry... If anyone has any websites or anything with good information on trachs, it would be wonderful! Thanks in advance!

[traumamedic]

Moving this up in the forum; I'm interested in the answer myself.

[LPNer]

Originally Posted by happylush

Hey everyone. I have a question. When you have a patient that has a cuffed trach, are you supposed to deflate the cuff before removing the inner cannula or not, and what is the purpose of it? Trach's still confuse me and scare me little bit..... I see everyone doing things different ways in the hospital and want to now what is the right way? Do the cuffs just help prevent aspiration? Sorry... If anyone has any websites or anything with good information on trachs, it would be wonderful! Thanks in advance!

I don't work with trachs much anymore (on an ortho unit now) but I have worked with them extensively, both old established trachs in home care and brand spanking new ones in the hosptial.
You do not have to deflate the cuff to change or remove the inner canula. However, if there is a plug, deflating can help the pt breath while you are caring for the trach. Also, I have found the inner cannula kind of hard to remove after the family has been taking care of the pt for a day or two and it is less traumatic to the trach to deflate the cuff while wriggling the inner canula free. Alas, in most of those cases two wriggles and you know you really do need to change the whole thing anyway.

Long and short of it, I've done it both ways more times than I can remember to count. Doesn't seem to make a difference except as noted above.

[traumamedic]

Thanks for the reply!

[pediatriclpn]

I have never had to deflate the cuff to remove inner cannula. Have deflated cuff so Pt. could vocalize. But that is about it. Good luck, a little bit of fear is good around trachs, esp. peds, they don't usu. have inner cannula. But don't let too much fear keep you away!

[nurseygrrl]

I have never deflated the cuff and I have had a lot of trach patients...

[hollyster]

Originally Posted by pediatriclpn

I have never had to deflate the cuff to remove inner cannula. Have deflated cuff so Pt. could vocalize. But that is about it. Good luck, a little bit of fear is good around trachs, esp. peds, they don't usu. have inner cannula. But don't let too much fear keep you away!

I agree. Fear is usually do to insecurity. The more you care for trached pts the more comfortable you become.
Remember to reinflate the baloon when ever you let the cuff down. One hard cough and the whole trach can become dislodged.

[VegasNurse05]

What about Bivona trachs? How do you clean those?