Trach tubes popping out of patients

Published

I am hoping to work with children in the home with trachs. I am wondering how often these tubes pop out. It sure sounds scary to me. I have no trach experience. Have you ever had a tube pop out? How often does this actually occur? What's the best way to prevent this from happening? Any information would be greatly appreciated. Thanks:p

Specializes in LTC, Memory loss, PDN.

I've not had a trach pop out and I've rarely had the luxury of two extra hands with trach care/change. I have had several rascals/pullers, but regardless of that, always be prepared to reinsert a trach, Have a spare trach and lube ready at all times. Observe trach site for granulation and scar tissue every shift as this can hinder reinsertion.

Up Vote Up Vote ×
My client's trach tends to pop out when his head bends back, no matter how tightly the ties are tied. It usually happens during a diaper change. I just pop it back in.

OMG!!!!! How scary!!!!!!!:eek::eek::eek:

Up Vote Up Vote ×
I've not had a trach pop out and I've rarely had the luxury of two extra hands with trach care/change. I have had several rascals/pullers, but regardless of that, always be prepared to reinsert a trach, Have a spare trach and lube ready at all times. Observe trach site for granulation and scar tissue every shift as this can hinder reinsertion.

You have had several rascals/pullers!!!!! OMG:eek: Yes, I guess I better be prepared for the unexpected.

Up Vote Up Vote ×
Specializes in LTC, Memory loss, PDN.
You have had several rascals/pullers!!!!! OMG:eek: Yes, I guess I better be prepared for the unexpected.

Not all kidos pull on their trach intentionally. Sometimes they get their fingers caught in the trach tie and unintentionally pull on it. To minimize this, change trach ties daily whenever possible, keep area clean dry and free from irritation, make sure split gauze is in place so trach ties don't scratch skin. In some cases, placing a bandana over the trach can help keep busy fingers at bay.

Up Vote Up Vote ×

My patient is a trach puller too! I just graduated with my LPN in September, so my job as a PDN is my very first job as a nurse. Like you, I was petrified by the vent and the thought of her trach coming out. I work 3rd so I had added concern as to what I would do if something happened in the middle of the night. I have been on this job for 2 months now, and now I'm pretty confident in my abilities to care for her and her trach/vent. There is still a lot to learn, but I am learning as I go, and her mom is always there, so I know she would be 'Johnny on the spot' if something were to happen. As far as my pt goes, she is bad about pulling at her tubes (she has a Mic-Key as well), but I just have to constantly redirect her, and keep her hands busy with something else. I don't let her out of my sight unless she is sleeping. This means I don't get to use the restroom or anything else that involves me leaving her room until she is in a good sleep, which is usually around 1am if I'm lucky (I work 7p-7a). It can be a pretty stressful job, but I am gaining awesome experience, and I am blessed to able to be a part of her life! She is precious, and a true miracle. I am honored to be her nurse.

If this is truly something you want to do, then go for it! :)

Up Vote Up Vote ×
+ Join the Discussion