Help guys, how can we express the size of the tracheostomy tube?

sasha1224 · Sep 11, 2008

From what I have read it is based on the INNER diameter of the tube. The obturator is for easier insertion(re-insertion). Put the obturator inside the trach, insert, and once in, quickly remove obturator as it obstructs the trach. Hope this helps. :)

icyounurse, BSN, RN · Sep 11, 2008

In our charting it shows up "mm ID" which I think is millimeters inner diameter. 6-9 mm ID are common sizes I believe. Hope this helps!!

Melandru · Sep 11, 2008

thanks for the help guys, but i read in a book it is expressed as FRENCH and when we say french, it means the INNER DIAMETER so I guess both are correct...

Pipsqueak, ADN · Sep 11, 2008

thanks for the help guys, but i read in a book it is expressed as FRENCH and when we say french, it means the INNER DIAMETER so I guess both are correct...

All of my pts are trached. I've never heard of describing the size as "french". As a matter of fact, I routinely change my clients trachs, and nowhere on the box is the word "french" used. The poster that stated its is in mm ID is correct. When I chart trach size, I chart the size, and type of trach. For example: 3.5 Neo Shiley or 4.0 Ped Bivona. Hope this helps. Also the trach size should be listed directly on the flange of the trach.

Annony RN · Sep 11, 2008

Just as comparison, think how tiny an 8fr foley is and how large a #8 trach~

Rnandsoccermom · Sep 11, 2008

I've worked with respiratory pts for 21 years and my husband is a RT. I've only ever heard the word "size" used ex: size 7, size 8, never "french" etc....

Also, easy thing to remember, when intubating with an ETT, you can equate the size tube you need roughly with the size of the pts middle finger.

Melandru · Sep 12, 2008

Guys if it is in size, what are the pediatric size and the adult size? and is the size the same as the diameter in mm?

like... size 5 is = 5 mm diameter?

Pipsqueak, ADN · Sep 12, 2008

Guys if it is in size, what are the pediatric size and the adult size? and is the size the same as the diameter in mm?
like... size 5 is = 5 mm diameter?

I'm not sure what the typical adult sizes are as I am a peds nurse, but here is how the sizing works in the Shiley and Bivona trachs:

Example: "3.0 Neo Shiley": 3.0 refers to mm Id (mm of inner diameter). There is also an outer diameter measurment expressed as mm Od. We only document the mm Id when documenting the trach size.

Example: "4.5 Ped Bivona": Again 4.5 refers to the mm Id.

On the outside of the box of a brand new sterile trach, the size is written in large bold print, ex: "4.0 PED". The specifics such as the inner and outer diameters are written in the fine print on the package insert. The size of the trach is also written on the flange of the trach itself (at least on the Shiley's and Bivona's) and will also just say for example, "4.0 PED".

Shiley and Bivona are two different styles of trachs. Bivonas are used when the child is also on a vent. Shileys are mostly used if the child is not vented. Shiley's can be used with a vent, just not as convenient as the Bivona.

Neo and Ped refer to the length of the trach. Neo's are shorter and Ped's are a little longer. Bivona also makes a Ped Long, which is slightly longer than the reg Ped size. And if you ever needed to know that exact length, this is also written on the package insert and expressed in mm.

There is no inner cannula for these style of trach's. We change the whole trach out once per week and as needed for plugging. Shiley's are disposable, we insert a brand new sterile one each week. The Bivona's are reusable. At least 2 are kept in the home to change them out. They are rinsed free of any secretions, then "sterilized", by bringing a pot of water to a boil, removing from the heat source, then placing the trach in the water for 20 minutes, air dried and placed in a clean baggy for use for the next trach change. Obviously this is home care, and the procedures are way different in the hospital.

The smallest size I see in the pediatric population are 3.0 Neo, and the largest size is usually 4.5 Ped. I do have one client who is the size of an adult and he wears a 5.5.

Hope this helps.