Many people use different types of trachs depending on their specific
needs. I currently use a cuffless Shiley size 6 trach..fenestrated.
Fenestrated means that when the trach is capped off, a person can talk.
There is a hole (or fenestration) in the tube that enables speech.
>Since using an inflatable cuff prohibits speech, why does someone need to
> use one?
A cuff helps seal in the air when on the vent so there is little
possibility of leakage. Alot of people deflate the cuff during the day so
that they can talk, etc.and then inflate the cuff at night.
Again, this type of trach is specific to both a doctor and patient's
preference or need.
> Is it possible to adapt by deflating it when you want to talk, or is that
> not worth the trouble?
Deflating the cuff isn't terribly difficult. As you stated, people adapt.
> Does the cuff improve pressure and prevent infection that much more
> effectively than the Jackson tube or other types?
The cuff doesn't prevent infection, in fact, in my case..when having a
cuffed trach and having it in too long can increase the risk of infection,
(not necessarily cause it).
> What does it take to manage infection and secretions well
Drink plenty of fluids to thin fluids, use the humidifier that connects
with the vent. Suction when necessary or cough secretions up.
> Is doing suction a difficult routine to keep up effectively?
Again, people do adapt. At first suctioning is a scarey thing..having the
air sucked out of you trying to get mucus up. But as time goes by, it is
just a way of life.
There are days I suction 6 to 8 times a day..and others, not at all.
> How often do trach changes really need to happen?
Trach changes depend on what both patient and doctor agree on. I have gone
as long as 6 months without a change. I was checked by myself, doctor, and
partner for signs of infection. If daily cleaning the trach area occurs
daily, trachs can be kept in for months. My doctor doesn't like me to
change alot..due to irritation to the tracheal wall..which could cause
bleeding.
At the present time I change about every 6 to 8 weeks.
> Do suctioning and tube changes easily irritate the tissue and cause more
> secretions?
Suctioning for me doesn't not cause mucus ...irritation, but the trach
change does.
> Do alarms go off when they're not supposed to?
Usually the alarms go off for some purpose according to the specs of the
vent and the individual settings. When trying to talk on the vent..the
alarm can sometimes go off. Better alarms go off..than not at all.
> How many vent users can only breathe on their own for ten or fifteen
> minutes? Or less.
I can breathe on my own during the day..I have post polio syndrome and use
the vent while sleeping at night or napping during the day. When I have a
lung infection I use the vent more.
> How good a job did rehab do of setting up optimal equipment and procedures,
> or do people tend to learn what they really need from experience?
When I first got the permanent trach and vent over 4 years ago..both the
RT, doctors, and ICU were excellent in training my partner, me, and my PA's
in trach cleaning, suctioning, vent settings, etc. I was not allowed to go
home until both my partner Jim and my PA were taught CPR. I must say
training was excellent.
Gary, if you need answers to anymore questions, etc. Feel free to let me
know.
Annette Hanna
nete1(AT)midwest.net
> Thanks for any help.
>
> Gary Karp
> Author, Life On Wheels