Trach care

You should not deflate the cuff, the inner cannula is a seperate piece and should be easily removed. The best thing to do is check policy in your facility and ask someone to walk you through it just to be absolutely sure about what you are doing.

You should not deflate the cuff, the inner cannula is a seperate piece and should be easily removed. The best thing to do is check policy in your facility and ask someone to walk you through it just to be absolutely sure about what you are doing.

Thanks! I thought I was doing something wrong and when I go to look up in my nursing books to see what they recommend it says " cuff must be deflated before removal of cannula" in bold print. I haven't heard the reasoning as to why it would matter, and being that it is a separate piece, I wouldn't think it would jeopardize the airway in any way by leaving it cuffed. I just got scared because my patient developed a hard time breathing right after my trach care/repositioning, etc and thought at first maybe it was something I had done, being I havent worked with too many trach's yet to feel comfortable with them completely and they still make me pretty nervous!

Your nursing book was correct in that you would need to deflate cuff before removing the (outter) cannula, however not for removal of the inner.

You may find some of the links in this thread helpful:https://allnurses.com/forums/showthread.php?t=80310

Thanks for your info. I have always been afraid that even removing the outer cannula could be trouble and somehow the airway would close. I think the more I work with the trach's the more comfortable I will become and it will just take time.... thanks again! :)

The cuff only needs to be deflated if you are taking the inner cannula out and replacing it with a Passi-Muir valve (used for speaking) and it should not be reinflated until the Passi-Muir is removed and the inner cannula is inserted again. It the cuff is inflated when the Passi-Muir valve is in place, the patient will be unable to exhale. Otherwise, if you are just taking the inner cannula out for trach care, you do not need to deflate the cuff. Hope this helps!

Cuffs only need to be deflated when you are completely changing the entire trach as in downsizing from say #6 to #4 or trouble with a blown cuff balloon. Routine trach care does not require cuff deflation.

PMV was made to be place on the inner cannula.....do NOT remove inner cannula to put on PMV.

Some trach plugs (usually red) require removal of inner cannula; but, preferred method is to keep inner cannula in to avoid plugging in entire trach. If mucous clog occurs, inner cannula can be change (if disposable) or cleaned (if NDIC-Non disposable inner cannula). If there is no inner cannula when mucous clog occurs, the entire trach has to be changed.

I also have a question about trach care. I am a new nurse in a facility for severly mentally developed children and some have trachs. During my training I am being taught trach care by other nurses, my problem is that when oral or nasal suctioning is required the nurses first suction the trach and then(without changing the suction tube) they start oral or nasal suctioning. I have never seen trach suction then oral or nasal suction done without changing the suction tube. Is this standard practice. Pls advise. Thanks