Question about Trachs

Super_RN, BSN, RN · Nov 4, 2005

Sure! Not all inner cannulas are disposable although it is more common now. Take the cannula out, dip it in peroxide, scrub it, rinse with saline and put it back in in a matter of seconds :)

Jaime

KatieBell · Nov 4, 2005

When I worked ICU- we used to clean out the inner cannula in a trach care kit and replace it. It was actually one of the procedures that used to make me nervous.

Back in the day (before my time) there were metal trachs, I believe they were called "steely Jacksons"??

Thunderwolf, MSN, RN · Nov 4, 2005

Oh, yes. Remember it well....and really not so long ago.

Tweety, BSN, RN · Nov 4, 2005

Yep.

Remember using sterile technique of course. :)

The disposable inner cannulas should be disposed and changed while in the hospital. I've never heard of reusing those Shiley inner cannuals.

Daytonite, BSN, RN · Nov 4, 2005

We had patients with silver metal trachs (called Jackson's, I believe)which are not disposable and do not have a cuff. If a patient was being switched to a "talking trach", it was metal. These metal trachs needed to be removed and cleaned periodically because goobers collect and dry on them since they have no cuff to prevent air from passing by them and drying up any sputum clinging to the outer part of the trach tube. Cleaning dried up goobers from a trach is as bad as cleaning pots and pans with caked on cooked meat and fat. :wink2: Central supply only had a few metal trachs so we couldn't be calling for a new unit all the time. We would remove the entire trach unit, soak it in peroxide, scrub it with the brush that came with the trach cleaning tray and rinse it in sterile water, then reinsert it. If the trach is kind of becoming a permanent fixure, the whole trach unit can be removed, cleaned and reinserted quite easily if you have the obturator. I'm guessing they are doing this if there is no new sterile one on hand or because of the cost of a new trach unit. If you really want to be cheap and test the gods of infection control you can remove the entire plastic tracheostomy tube, clean and reinsert it if sterile technique is used.

We would clean disposable inner cannulas also if we were running low on the supply the patient had in his room and central supply was telling us they didn't have any more in that particular size. :uhoh21: This is that creative mother of invention kind of stuff you sometimes have to come up with.

suzanne4, RN · Nov 4, 2005

Pediatric trachs do not have inner cannulas. It is quite common to have an extra at the bedside to change out, you place the one that was waiting, and have time to clean the one removed and replace it the next time. This is routinely done all over.

It is actually a clean procedure, not a sterile one.

sjb2005 · Nov 4, 2005

Sure! Not all inner cannulas are disposable although it is more common now. Take the cannula out, dip it in peroxide, scrub it, rinse with saline and put it back in in a matter of seconds :)
Jaime

Shiley's have plastic disposable inner cannula that are replaced daily. Jackson's are metal and they are removed and cleaned every shift just as super rn describes. I think buvonas are also metal. I think a passe-muir valve only fits on shileys though, i could be wrong about that. Jacksons can be pugged for vocalization and weaning.

TexasPediRN · Nov 4, 2005

Its perfectly fine to 'rinse and reuse' trachs. Just a few items though:

Shileys are disposable, Bovina trachs are not (custom made and cost a lot so you clean and reuse)

As for the above post just a small correction: you can use passe-muir valves on bovinas, they fit perfectly too :)

Bovina trachs are plastic outside, but do have a metal coil on the inside. Shileys are all plastic.

papawjohn · Nov 4, 2005

Hey Y'all

Man, I feel so nostalgic for the little section of the 'trache care kit' that you poured the peroxide and saline into (swimming with strange slime) after the bottle-brush---anyone but old nurses remember bottle brushes?---scrubbed out the re-usable inner-cannula. Ahhh yes, those were the days. Before AIDS. And best of all---remember a kind of hepatitis called (really!!!) Non-A, Non-B Hepatitis. (Kill-joys now call it Hepatitis C.)

Gosh. What great days.

Grumble Grumble

Papaw John

BBFRN, BSN, PhD · Nov 4, 2005

We still use metal trachs after downsizing and if they are going to have them long term. We clean them as described above.

sjb2005 · Nov 4, 2005

Its perfectly fine to 'rinse and reuse' trachs. Just a few items though:
Shileys are disposable, Bovina trachs are not (custom made and cost a lot so you clean and reuse)
As for the above post just a small correction: you can use passe-muir valves on bovinas, they fit perfectly too :)
Bovina trachs are plastic outside, but do have a metal coil on the inside. Shileys are all plastic.

Thanks for the info. I wasn't to sure about a few things.:)