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Discussion

Decannulating...

I work on a Pulmonary floor and I have discussed with co-workers and my previous preceptor what they would do if they decannulate. My hospital's policy is PIA to get to (and I will on next shift but the computers were down when it was in my brain).

I have an idea of what I would do, but I was just curious about seasoned veterans and what they would do?

Also in the case of an emergent event like this, what would you keep in mind to stay calm and use your critical thinking skills?

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If a patient pulls out their trach, have someone call RT and in our facility, whoever finds the patient puts it back in. Hopefully you have an obturator taped above bedside and/or a replacement trach. Put the obturator in the trach, lube it up, slip it back in, take out the obturator and inflate the cuff (if there is a cuff). Then tie that sucker in! Ideally this is all done in a sterile manner, but depending on their respiratory status, that might not be the case.

If you cant get the orginal trach back in, simply take a 6 cuffed ET tube and insert it in place of the trach. Works like a charm

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