Pediatric Tracheostomy

[katnursey]

Has anyone ever heard of air getting into a completely deflated trach cuff? As far as I know, no one injected the air. This child has a trach that we were keeping the cuff filled with 1.5ml to 2 ml of sterile H2O, as ordered. Has been weaned down to no H2O in the cuff. Air was noticably in the cuff this morning, as the balloon was inflated. Balloon was completed deflated all day (8 hrs). Received a text a while ago as I am off duty, stating, FYI that cuff gets air in it somehow.

[R. Obias Jr., R.N.]

Yes, it is physically possible for air to get into the cuff without anyone injecting it. Any attending nurse can possibly miss it for it occurs inside the throat are and most often requires a certain amount of time before the air fills up. And this may possibly occur while the patient is asleep. If the trach is connected to a regulated air supply, when the patient is asleep there are times when the breathing pattern of the patient changes requiring the natural body functions to react in order for the body cope up with the changes. This happens when a patient breaths, if the regulated air flow is not enough for the body's need at a certain period, the human body triggers a muscle in the body in order for it to take a deep breath to catch up on the loss of oxygen. This action creates a vacuum inside the throat area that forces the trach cuff to expand thereby pulling air into the bag thereby filling it up via a small amount at a time until it fills up. The problem here was that the screw cap where the air was introduced into the cap was not properly closed or has a leak , allowing air to be sucked in. Hope this clears your worries, unless a nurse who have not tried inflating a cuff played around the device and forgot to deflate it, that would be the worst thing that could have happened...