Tracheostomy ventilation

[GASPER20]

For a patient with a cuffless tracheostomy tube, is it possible when you hook them up to the vent to not see adequate TV or ETCO2? Could the patient be breathing around the trach site via their mouth/nose and therefore I can't detect it?

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[anbuitachi]

For a patient with a cuffless tracheostomy tube, is it possible when you hook them up to the vent to not see adequate TV or ETCO2? Could the patient be breathing around the trach site via their mouth/nose and therefore I can't detect it?

yes

 

[Hork Bajir]

My favorite technique for the cuffless trach that you don’t want to change: place an LMA, and then place a clamp across the LMA instead of hooking it up to anything. Wouldn’t do this for a long procedure, but for a 5 minute thing it works surprisingly well

 

[btbam]

For a patient with a cuffless tracheostomy tube, is it possible when you hook them up to the vent to not see adequate TV or ETCO2? Could the patient be breathing around the trach site via their mouth/nose and therefore I can't detect it?

Uh yea it's called a leak.

 

[deleted875186]

For a patient with a cuffless tracheostomy tube, is it possible when you hook them up to the vent to not see adequate TV or ETCO2? Could the patient be breathing around the trach site via their mouth/nose and therefore I can't detect it?

Leave the cuffless trach and let them breath spontaneously for short cases were you have access to the head. Anything other than that, I’d get them deep on gas and than change to a cuffed for controlled or assisted ventilation.

 

[woopedazz]

My favorite technique for the cuffless trach that you don’t want to change: place an LMA, and then place a clamp across the LMA instead of hooking it up to anything. Wouldn’t do this for a long procedure, but for a 5 minute thing it works surprisingly well

Just tape their air holes closed with duct tape.
Or, wheel them into the emergency department and ask them to place an ETT; perfect Sengstaken-Blakemore tube every time.

 

[2Fast2Des]

My favorite technique for the cuffless trach that you don’t want to change: place an LMA, and then place a clamp across the LMA instead of hooking it up to anything. Wouldn’t do this for a long procedure, but for a 5 minute thing it works surprisingly well

Yeah but wouldn't it leak around the stoma site regardless of seal above?