Teaching coughing and deep breathing with tracheostomy?

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Okay, I've looked and looked and cannot find a good source of information on teaching coughing and deep breathing for someone with a long term tracheostomy. I was practicing teaching for a postop patient and realized if my patient had a trach I wasn't sure how to teach this. I googled and searched my textbook and other books and am a little frustrated that I can't find any info on this. Surely trach patients have to be taught coughing and deep breathing. Shoot I'd think they'd be more at risk for respiratory complications and need it more that other patients. Anyhow, how would you teach coughing and deep breathing to someone with a permanent tracheostomy?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I am in a hurry...this may help...I'll be back soon....http://www.tracheostomy.com/resources/pdf/TrachHandbk.pdf

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Thanks, I did look at that link and a few others actually before posting here. I guess my questions are does the patient cough up the mucus through the tracheostomy or through their mouth? I am thinking I would skip the breathe in through their nose and out through the mouth part, but I guess I get a little confused on this.

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Typically, in a patient with a tracheostomy tube the secretions are going to be coughed into the tracheostomy tube. In un-cuffed tubes, tubes with the cuff deflated, or fenestrated tubes, it's possible, but unlikely, that a small portion of the expectorated sputum might bypass the tube into the patient's mouth.

You might find the National Tracheostomy Safety Project website helpful, as they provide several resources. If you are unfamiliar with tracheostomies, you might find their NTSP Manual 2013 (PDF file) helpful.

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Thank you. That was what I thought, but wanted to confirm that.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Thanks, I did look at that link and a few others actually before posting here. I guess my questions are does the patient cough up the mucus through the tracheostomy or through their mouth? I am thinking I would skip the breathe in through their nose and out through the mouth part, but I guess I get a little confused on this.

THey still "think" that they breathe through their mouth and will make the motion when asked to take a deep breath.

It is possible that they might get some phlegm in their mouths but it will take the path of least resistance and out the trache....

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THey still "think" that they breathe through their mouth and will make the motion when asked to take a deep breath.

It is possible that they might get some phlegm in their mouths but it will take the path of least resistance and out the trache....

Thanks. I thought it would come out the trachea, but I wasn't 100% sure and I've gotten really nervous about saying anything unless I'm 100% sure.

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