Nasonex use for trach patients?

[smartnurse1982]

I am noticing an increasing number of children with trachs and vents that are using prescribed Nasonex and Flonase long term and year round.

I could understand if they were used for allergy season or when the kiddos have a cold,but for years even if the nose is clear?

However,I am confused,because esp with the Nasonex,the mucus in the nose goes down into the trach,which we then have to suction.

The nasal secretions tend to be thicker when they go down in the trach. Some have secretions coming from the stoma.

[brillohead, ADN, RN]

I would think that the nasal spray is to reduce production of nasal secretions which will then drain post-nasally (and, as you noted, need to be suctioned).

I have year-round allergies (dust / dust mites / mold) in addition to seasonal allergies (pollen), so year-round use makes sense.

If you feel that the child's secretions are too thick, perhaps request a guaifenesin order to thin them.

[smartnurse1982]

When I use Flonase,the secretions do not go into the trach.

It with the Nasonex use,which i kind of find odd,because the nose is decongested,but the trach gets the extra mucus instead.

I guess the post nasal drip has to go somewhere.

Another unrelated thing i am seeing is Pulmonologists switching from nebulized Albuterol to MDI with chamber Albuterol for trach/vent patients.

Some prescribe it to attach to the vent circuit,while others prescribe it to be given via the mouth and nose.

One doctor wrote to just occlude the trach while giving it.

[morte, LPN, LVN]

why aren't the secretions going to the stomache?