My mother had a stoma and the family, me included, where to change these out every day with her. She had an open throat due to excessive radiation and not being able to graft over. But after her passing, just over a year ago, I've decided to start in RT. These videos and this channel have helped me solidify my decision to do so. I feel this may actually be my calling. A little late in life to make a big change and I know it's going to be a challenge, but I am determined. Thank you for these informative videos.
Thank you so much!!! I am a new nurse in neurosurgery and we get a lot of trachs .. needless to say, I hadn’t done trach care since my junior year of nursing school and so my first time suctioning was nerve wracking ...I am much more comfortable now with my trach patients ( was even able to take care of my patient who suddenly developed a mucus plug while being capped and desaturated -yikes! Got her stabilized and all by cleaning and suctioning etc ) but it’s still nice to have everything explained bc we don’t get these nice in depth discussions in nursing school 😭... anyway, RTs are amazing - thank you for all you do 1 second ago
You are awesome! thank you so much! I'm in nursing school, and reading things just isn't the same until you see an actual demonstration, I appreciate you!
I can't tell you how much more comfortable this makes me feel in my knowledge to care for patients with trachs. THANK YOU THANK YOU THANK YOU for making this and making it easy to understand!
You are an amazing teacher. I am a nursing instructor and will be using this and your other respiratory videos. Thank you so much for sharing your expertise!
SLP/SALT here, amateur in an acute care setup.. This video has been immensely helpful and insightful ( and entertaining :P) I have recommended it to a couple of like-minded colleagues.. So so good! Such a detailed video with practical demonstration really helps understand the subject better and retain information for future use.. Thank you!!
Wildly helpful. I did my final preceptorship before graduation on an ICU step-down that was known for trachs and respiratory issues. I wish I had known all of this back then. RTs are the bomb!
Good Video. Another suggestion will be a video showing how to set up a Newly arriving Trached Patient's room with all necesary devices such as LVN, water traps, Suction devices etc. Thanks
Thank you so much. I’m a Respiratory tech and wanted to know the difference so when I get called to do trach care I can know what kind of Trach I’m dealing with.
Awesome vide and very detailed! My dad will hopefully getting his trach removed in few days.. I am nurse as well and this very helpful ! THANKS V MUCH👏👏🙏😍 Thanks v much
He knows his stuff. Maybe I should do some care & maintenance of them from a personal experience. I have a Tracheostomy & use the Shiley 7XLT cuffed. I've been having mine since December 2012. Mine is irreversible due to CO2 retaining but I'm ok with it. I only get 30 inner cannulas per month so I'm only able to change it once a day.
Pt with radical neck dissection sent home with a red cap on cuff less tracheostomy but it could not be removed for suctioning nor were there any MD orders. How do you remove red capped cuff less trachesotomy?
They are not difficult to remove, but you really should not remove it unless you have a doctor's order. I would call your physician's office today ..if that doesn't work, try the hospital unit that discharged you.
I have a quiz on trach care on Monday-very helpful video. Having previously BEEN trached, you’d think I know more. Unfortunately, I wasn’t really aware of my surrounding at the time :( Thanks! I’ll be sharing with my cohorts from RT school :)
Thank you! I'm so encourage to hear you are in RT school. You will have the ability to truly relate to trached patients like no other RT. It will help you to be a great therapist and even better caregiver!
I am looking for a text reference that says that the cuff does not secure the tracheostomy tube in place, but rather the trach ties (as you said at 21:10). Please help. Also- how much sterile water do you use to inflate the Bivona TTS cuff?? Thanks so much. You have awesome videos. You are a great teacher.
The amount of sterile water is going to vary by the size of their trachea. Continue to instill sterile water until minimal leak or minimal occluding volume is met. Minimal leak is the safest for tissue, but might allow for microaspiration. I like to use minimal occluding volume.
Sure. The trachea is located anterior to the esophagus. All contents going through the stomach pass through the esophagus. The fluid should never come from the mouth to the trachea unless there is some dysfunction of the epiglottis.
Excellent video and very well explained. Many thanks. Just one question. If you are using a non-cuffed fenestrated trachy, is there a fenestrated cannula for them? or are all the cannulas the same?
Trach ties secure the trach and are commonly a strap that goes around the neck holding the trach device in place. A trach collar is an aerosol mask that goes over the tracheostomy for nebulized medication or humidity. It doesn't secure the trach
I did an Inservice on oxygen devices about 3 yrs ago for my local home health/hospice company. I would be willing to do a zoom meeting if you think it would be beneficial😁👍
I've seen the hyper flex trachs used on patient that can't seal in a standard trach length. Mostly used in morbidly obese patients that may require a different length of tube to seal and remain in place. These patients need the depth monitored closely because they tend to slip up and down when a lot of mucous gets on the phlange.
Do we inflate or deflate the cuff when pt is bagged? And do we bag pt with inner cannula or w/o inner cannula to have a better saturation? Thank you so much
Awesome. As a critical care RN of 37 years and nursing instructor, I "learned" some stuff! I've bearly seen the speaking valve, so that's helpful (especially, if the patient is in respiratory distress and needs to be switched out to a non-fenestrated/cuffed one).
Each inner cannula is specific to the tracheostomy device. For example, Shiley 8.0 DCT inner cannulas should only be used with a Shiley 8.0 DCT tracheostomy device.
I believe the soft seal portex is air filled instead of sterile water filled. I prefer air filled. The cuff is also tapered to prevent microaspiration.
For water cuffed trache,what if we inflate it to make sure no water is dripping before we insert,because it will be a mess if you insert and water drips.
My 9 month old son has the Shiley.... but they gave him the Bivonna. I switched back to Shiley. Shiley is better for him in my opinion... but his are Neo and don't look like these adult sized ones.
I've seen a lot of bivonas in infants and children. The most important factors are patient comfort and in little one, parent comfort with the device. Sounds like you are making a good decision.
The inner cannula is disposable. It allows for quick and easy cleaning of the trach tube. Commonly the used inner cannula is disposed of once per day and a new, sterile inner cannula is inserted.
In most cases, yes. This would allow air to flow in/out the tracheostomy and in/out their oropharynx. I would be sure to suction any secretions from above the cuff before deflating.
hi I have two question that google are to lazy to help so number 1 can people with a trach eat? is there anyway(no disrespect) not not sound like a robot and I ask that not to be spiteful just asking I may as well be mute if I cant talk normal
Good questions: 1. Yes, you can definitely eat with a tracheostomy. The esophagus lies behind the trachea in your neck and is not affected by an apparatus in your trachea. 2. Yes, To produce a more natural voice the person will probably have to generate more airflow from their lungs. It is going to take some time and training but is definitely possible.
I think you are referring to an HME attached to a tracheostomy. HME-heat moisture exchanger. This helps to heat and humidfy the air before it reaches the airways. This will keep mucous more viscous and mobile.
My mother had a stoma and the family, me included, where to change these out every day with her. She had an open throat due to excessive radiation and not being able to graft over. But after her passing, just over a year ago, I've decided to start in RT. These videos and this channel have helped me solidify my decision to do so. I feel this may actually be my calling. A little late in life to make a big change and I know it's going to be a challenge, but I am determined. Thank you for these informative videos.
Thanks for making this video you explained it better than any book
Thank you so much!!! I am a new nurse in neurosurgery and we get a lot of trachs .. needless to say, I hadn’t done trach care since my junior year of nursing school and so my first time suctioning was nerve wracking ...I am much more comfortable now with my trach patients ( was even able to take care of my patient who suddenly developed a mucus plug while being capped and desaturated -yikes! Got her stabilized and all by cleaning and suctioning etc ) but it’s still nice to have everything explained bc we don’t get these nice in depth discussions in nursing school 😭... anyway, RTs are amazing - thank you for all you do
1 second ago
Thank you! I bet you are a pro now since it took me a year to respond 🤣😅
Fantastic thorough illustration. I will rewatch. Thank you.
You are awesome! thank you so much! I'm in nursing school, and reading things just isn't the same until you see an actual demonstration, I appreciate you!
I can't tell you how much more comfortable this makes me feel in my knowledge to care for patients with trachs. THANK YOU THANK YOU THANK YOU for making this and making it easy to understand!
You are an amazing teacher. I am a nursing instructor and will be using this and your other respiratory videos. Thank you so much for sharing your expertise!
Thank you! Let me know if there are other topics you would like me to cover.
SLP/SALT here, amateur in an acute care setup.. This video has been immensely helpful and insightful ( and entertaining :P) I have recommended it to a couple of like-minded colleagues.. So so good! Such a detailed video with practical demonstration really helps understand the subject better and retain information for future use.. Thank you!!
Thank you!
Thanks. You have a real mastery of your craft sir RT.
Thank you for this video. I am an RN with VERY little experience with trach care. This helps a lot!
Wildly helpful. I did my final preceptorship before graduation on an ICU step-down that was known for trachs and respiratory issues. I wish I had known all of this back then. RTs are the bomb!
Great video! Really appreciate you taking the time to explain the various types, features, and safety precautions.
I am in RT school now. I am totally unfamiliar with trachs, so your video is very informative. Thank you!
Good Video. Another suggestion will be a video showing how to set up a Newly arriving Trached Patient's room with all necesary devices such as LVN, water traps, Suction devices etc. Thanks
I love this idea 💡 !!
Thank you so much. I’m a Respiratory tech and wanted to know the difference so when I get called to do trach care I can know what kind of Trach I’m dealing with.
It is real important to know sizes and types of trachs. Surprisingly I've met quite a few RTs that do not know them well.
as a new RT grad this stuff is gold. Real informative. I feel much better handling trach's now.
Thank you for this. Thee best explanation I’ve ever come across.
Thank you especially identifying the multiple types of tubes and when to use and how trouble shoot / avoid problems.
Excellent demo and clarify, thank you!
This is extremely helpful! It has all the answers I had in one... I'll subscribe, so please keep the great videos coming! Thank you.
Superb video! Please keep posting these video. Thanks Jimmy!
Very very good videos on Trach care easy to understand
Awesome vide and very detailed! My dad will hopefully getting his trach removed in few days.. I am nurse as well and this very helpful ! THANKS V MUCH👏👏🙏😍
Thanks v much
Great for him! I hope he does well!
Thank you Jimmy for this information , it's just what I was looking for
Beautifully explained!!
Great video!! Super informative!
You have taught me more than anyone else. Thanks.
Thanks for watching Sandra!
@@rtclinic You are most welcome.
Please continue to make content dude you are awesome !!
Very clear explanation. Thank you!
I love your channel, Ive been a nurse for 13 years, Where were you when I was in Nursing school? Great stuff!!!
Roxann Mclaughlin Thank you 😁
@@rtclinic I am in nursing school, and I love watching your videos Stuff makes way more sense
THANK YOU
all i needed to know are in this video. thank you very much.
Excellent presentation. Thank you!
Thank you sir detailed information I am lucky to find your channel sir clearly explained
Great video I will show to my nursing students this today
You rock! Thank you so much for this!! You made trach equipment so easy to understand :)
i know i'm late but this is AMAZING thank you !
Great video
Efficient demonstration.. very helpful
Nagyon szuper a video! Remek tanulási lehetőség! Köszönöm!
He knows his stuff. Maybe I should do some care & maintenance of them from a personal experience. I have a Tracheostomy & use the Shiley 7XLT cuffed. I've been having mine since December 2012. Mine is irreversible due to CO2 retaining but I'm ok with it. I only get 30 inner cannulas per month so I'm only able to change it once a day.
Once a day is a good frequency to change your inner cannula.
excellent video very helpful!!!
I watch the entire thing, good video
Pt with radical neck dissection sent home with a red cap on cuff less tracheostomy but it could not be removed for suctioning nor were there any MD orders. How do you remove red capped cuff less trachesotomy?
They are not difficult to remove, but you really should not remove it unless you have a doctor's order. I would call your physician's office today ..if that doesn't work, try the hospital unit that discharged you.
I really enjoy your videos, i was wondering if you can explain the different modes on the PB-840 (VC, VC+, Volume support, etc)
Thank you.
Thank you so much! Your video was incredibly helpful!
Awesome video. I was able to easily understand and learn about different trachs.
this was fantastic! thank you!
This video is so good! thank you for explaining everything so well!
Çok tatlısın Sarah ❤😘
Super fantastic video! The information is excellent!!! Thanks for sharing...
Thank you for brilliant explanation!!!
Do you jave videos on how to wean an adult from trach or testing for speaking valve
I have a quiz on trach care on Monday-very helpful video. Having previously BEEN trached, you’d think I know more. Unfortunately, I wasn’t really aware of my surrounding at the time :(
Thanks! I’ll be sharing with my cohorts from RT school :)
Thank you! I'm so encourage to hear you are in RT school. You will have the ability to truly relate to trached patients like no other RT. It will help you to be a great therapist and even better caregiver!
What an excellent tutorial!
I am looking for a text reference that says that the cuff does not secure the tracheostomy tube in place, but rather the trach ties (as you said at 21:10). Please help.
Also- how much sterile water do you use to inflate the Bivona TTS cuff?? Thanks so much. You have awesome videos. You are a great teacher.
The amount of sterile water is going to vary by the size of their trachea. Continue to instill sterile water until minimal leak or minimal occluding volume is met. Minimal leak is the safest for tissue, but might allow for microaspiration. I like to use minimal occluding volume.
This is really great information for a nursing student like me!! Thank you so much!
Thanks much for this video and understandable explanations! Would you be able to explain how one is able/if able to eat/drink with a trach? Thank you
Sure. The trachea is located anterior to the esophagus. All contents going through the stomach pass through the esophagus. The fluid should never come from the mouth to the trachea unless there is some dysfunction of the epiglottis.
Very helpful, thank you. Subscribed.
Thank you Dianne!!
Excellent video and very well explained. Many thanks. Just one question. If you are using a non-cuffed fenestrated trachy, is there a fenestrated cannula for them? or are all the cannulas the same?
What pressure should be on the manometer when checking the cuff pressure for minimal occlusion?
Usually less than 20 cmH20 but it will very from patient to patient
Also-what is the trach tie vs trach collar?
Trach ties secure the trach and are commonly a strap that goes around the neck holding the trach device in place.
A trach collar is an aerosol mask that goes over the tracheostomy for nebulized medication or humidity. It doesn't secure the trach
Can u put a speaking valve on a non fenestrated patient?
Yes. As long as it is a small diameter trach that will allow air to flow around it. These are almost always cuffless trachs.
Great video 👍 👍
Can you make a video on alarm settings Real world and NBRC.
I wonder if you could ever do a home health and hospice community in service
I did an Inservice on oxygen devices about 3 yrs ago for my local home health/hospice company. I would be willing to do a zoom meeting if you think it would be beneficial😁👍
Thank you, thank you and thank you !
I have a patient with a bivona hyper flex trach. Why would a doctor choose this over another trach?
I've seen the hyper flex trachs used on patient that can't seal in a standard trach length. Mostly used in morbidly obese patients that may require a different length of tube to seal and remain in place. These patients need the depth monitored closely because they tend to slip up and down when a lot of mucous gets on the phlange.
Thanks for the reply. My patient checks off on everything that you described and even so is very hard to keep a seal. Very positional.
Do we inflate or deflate the cuff when pt is bagged? And do we bag pt with inner cannula or w/o inner cannula to have a better saturation?
Thank you so much
Always inflate and attach the bag to the inner cannula.
Thank you for this video it kept me informed I just received a trach so this info was super important
Is there a special way to do a single cannula cuffless tube m6sct shiley?
Hello Alex,
What would you want to do with this trach?
@@rtclinic I need to replace one on my wife. Covid19 is preventing her from seeing her Docto to replace it. Way over due.
Email me with some specifics, location , dme, etc and I'll see if I can help you get one. Jimmy.mckanna@gmail.com
Great video! Thank you!
This is so helpful! Thank you, wondering if you can answer a question? When taking off a PMV does the cuff have to be immediately reinflated?
PMV?
@@rtclinic passy Muir valve
Not in every case. If the patient requires positive pressure ventilation or has aspiration issues, then yes it will need to be reinflated.
Great video. Very informative.
vik56in Thank you!
Awesome, i learned so much!
Is there a special way I can E-Mail you although I have a tracheostomy since birth.
Sure. Jimmy.mckanna@gmail.com
Awesome. As a critical care RN of 37 years and nursing instructor, I "learned" some stuff! I've bearly seen the speaking valve, so that's helpful (especially, if the patient is in respiratory distress and needs to be switched out to a non-fenestrated/cuffed one).
Thank you for this very informational video.
excellent explanation, thank you :)
GREAT VIDEO!!! THANK YOU SO MUCH!
Thank you sooooo much..You’re a great teacher..:)
How do you know what size the inner cannula should be?
Each inner cannula is specific to the tracheostomy device. For example, Shiley 8.0 DCT inner cannulas should only be used with a Shiley 8.0 DCT tracheostomy device.
What is the purpose of soft seal portex
I believe the soft seal portex is air filled instead of sterile water filled. I prefer air filled. The cuff is also tapered to prevent microaspiration.
For water cuffed trache,what if we inflate it to make sure no water is dripping before we insert,because it will be a mess if you insert and water drips.
That is a good tip for water cuffed trachs! Thanks!
My 9 month old son has the Shiley.... but they gave him the Bivonna. I switched back to Shiley. Shiley is better for him in my opinion... but his are Neo and don't look like these adult sized ones.
I've seen a lot of bivonas in infants and children. The most important factors are patient comfort and in little one, parent comfort with the device. Sounds like you are making a good decision.
What does the inner cannula do now? Please help
The inner cannula is disposable. It allows for quick and easy cleaning of the trach tube. Commonly the used inner cannula is disposed of once per day and a new, sterile inner cannula is inserted.
Fantastic info.
This is excellent. Thank you
Excellent video. Thank you
Love your video! It explained thoroughly.
Love love love ur videos
Thank you Suzi P !! 😊
If the patient is in cuffed tracheostomy tube and went on distress, will deflating the cuff help?
In most cases, yes. This would allow air to flow in/out the tracheostomy and in/out their oropharynx. I would be sure to suction any secretions from above the cuff before deflating.
Great info thanks! Love at first sight on this video 😅
Thanks for sharing
I want tracheostomy capped inner cannula only Do you have
I'm sorry. I can't sell the caps that I have.
wow amazing love how you explain it. the best
This video is goldddddddd.
Thank you !!
detailed visual video. thank you.
hi I have two question that google are to lazy to help so number 1
can people with a trach eat?
is there anyway(no disrespect) not not sound like a robot and I ask that not to be spiteful just asking I may as well be mute if I cant talk normal
Good questions:
1. Yes, you can definitely eat with a tracheostomy. The esophagus lies behind the trachea in your neck and is not affected by an apparatus in your trachea.
2. Yes, To produce a more natural voice the person will probably have to generate more airflow from their lungs. It is going to take some time and training but is definitely possible.
Thanks for sharing!
How do I forward my nursing school tuition to you? Interac?
I have Paypal! Bhahahaha! What are some other topics that I can cover to supplement your nursing program?
What is air filter in tracheostomy
I think you are referring to an HME attached to a tracheostomy. HME-heat moisture exchanger. This helps to heat and humidfy the air before it reaches the airways. This will keep mucous more viscous and mobile.
Send me a picture of it and I'll verify that it is an HME. jimmy.mckanna@gmail.com
thanks soooo much. excellent presentation