trach care???

Hey guys quick question!

I have a patient that has an extra long trach, and when doing trach care the brush gets stuck inside the trach..almost as if the brush is too big for the inner cannula.... Anyone ever have this experience? Am I supposed to be using a different kit?

Also what is everyone's policy on trach care? I am doing a PI on it and wanted to get some info.. Do you do it q 8 hours ... once a day or whatever if the patient has an old trach with minimal secretions that gets suctioned once a day if that...

Thanks guys

Is it the old metal trach and inner cannula? Are you soaking it in peroxide then rinsing with sterile water before using the brush? I guess if you still can not get inside the tip you could use the cotton tip applicators to clean the tip.

All of our trachs are the plastic shileys with the disposable innuer cannula. We change those once a shift with site care which is q12 hours in reality but I think it is q8h by policy, and then change the trach ties prn. Done in 10 minutes top. so much easier than the older trachs.

Its a plastic shiley.. it doesn't matter if its soaked or not.. once you get the brush in (with some resistance) it is really really hard to get out lol

On the plastic shiley we don't clean the inner cannula..they are disposable and not ment to be cleaned. we just take the old one out throw it away and put in a new one q8-12 hours. We just clean around the site them with 1/2 peroxide and ns. change trach ties prn.

if you are cleaning a disposable. please take the time to read the box they come in.....at one time it clearly stated they were to be disposed of and not cleaned, and i called the company about it and they wouldnt stand behind the product if you did clean and reinsert.....

I have a patient right now who also uses a Shiley #6 Extended. They are disposable and should not be washed and reused.

As for policy, we change the inner cannula once a shift, which is once every 12 hours. Obviously if the patient has a lot of secretions or really thick secretions we will change it more often. Trach ties are PRN.