Sleeping with HMEs (Trach noses) safe?

Specialties Private Duty

Published

I'm new to caring for tracheostomy patients and just started caring for a 4 year old with a trach in her home. We were trained that the patients should never sleep with an HME (heat moisture exchanger), but per mom she sleeps that way every night... What have you all seen with regards to that, whether in a home or hospital setting? The mom looked at me like I was crazy when I told her it wasn't safe for the patient to sleep with it.

Specializes in Home Health (PDN), Camp Nursing.

I think a lot of the thinking behind limiting the time HMEs are applied started when they were newer and didn't work as well. Also I think it is very patient by patient who can tolorate them for long periods and who can't I have had a lot who can and do go 24 hours. Others who after six are plugging.

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Specializes in Pediatrics, Emergency, Trauma.
Is she on a pulse oximeter? If so I don't see where this would be a problem.[/quote']

This; unless in the POC it calls for the pt to be on the vent or trach collar while sleeping; otherwise monitoring by Pulse Oximeter, and assessing the pt frequently is your best bet. :yes:

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Specializes in HH, Peds, Rehab, Clinical.

I did HH for a 2 yo with trach/vent. If she was on the vent, she had the HME running. She became horribly congested without it.

I'm new to caring for tracheostomy patients and just started caring for a 4 year old with a trach in her home. We were trained that the patients should never sleep with an HME (heat moisture exchanger), but per mom she sleeps that way every night... What have you all seen with regards to that, whether in a home or hospital setting? The mom looked at me like I was crazy when I told her it wasn't safe for the patient to sleep with it.
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Specializes in Peds(PICU, NICU float), PDN, ICU.
I did HH for a 2 yo with trach/vent. If she was on the vent, she had the HME running. She became horribly congested without it.

HME running? You mean the humidifier?

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Specializes in Pediatric Private Duty; Camp Nursing.

My aforementioned two-year-old actually is happiest when she has NOTHING on her trach. Most nights I come in and she's free and open, and on the dryer side, but never too badly. I unwrap a new HME and pop it on during her assessment, and document how I received her. Again, it's a tolerance thing. She's otherwise a perfectly healthy, typical child, so that definitely helps.

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Specializes in pediatric.

I cannot answer to the safety of wearing HMEs while asleep. However, my pediatric pt. wears his HME while out of bed and is on a trach/mist collar whenever in bed (as well as POX at night).

BTW, this is stated in my pt's POC. Ultimately it is up to the parent though.

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Specializes in LTC, Memory loss, PDN.

I think several different conditions are getting thrown

in one pot here

i believe the big concern would be the HME getting clogged

or full of secretions

if that is the concern, time of day and sleep/wake cycles are irrelevant,

but rather whether the pt is monitored

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Specializes in Pediatrics.
My aforementioned two-year-old actually is happiest when she has NOTHING on her trach. Most nights I come in and she's free and open, and on the dryer side, but never too badly. I unwrap a new HME and pop it on during her assessment, and document how I received her. Again, it's a tolerance thing. She's otherwise a perfectly healthy, typical child, so that definitely helps.

My patient is the same. She once used an HME 24/7, but now Mom has her with nothing on her trach much of the day (it has decreased the amt of secretions) at the request of her pulmonologist. I just follow her around all day and keep it as clean as possible. Like yours, she is incredibly healthy and has no issues.

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