“Time For A Tracheostomy Tube Change.” Chapter 118

When you own a home there are certain seasonal things you must do ever year depending on where you live. Most folks follow Daylight Savings Time as a reminder: Turn off the outside water spigots, change the smoke detector batteries, and even change the house AC/heating filters. For PALS living with a ventilator tracheostomy, there’s one more filter you need to change as well. Although its true that every house and person is different, everything on this list must be done for the best function possible.

It was time for my 4,380 hour ventilator change. Ideally, the ventilator should function properly for about that amount of time, but there are always conditions that could change that. For instance, when the ventilator is functioning properly, there are only a few daily tasks to keep up with:

Suctioning - which requires someone to suck the mucus out of the ventilator that builds up over time. To do this, the caregiver uses a special suction machine and hose, inserts it into the outer cannula hole down into the esophagus, and sucks the mucus out. It’s like using a wet/dry vacuum for your throat, only not quite so big and sucky. If the hose is inserted without care, it can damage the esophagus. Sometimes, even if you are careful, the esophagus can be scratched. This has happened to me before. It hurts and bleeds, and then you get over it!

Inner Cannula Change - this tube is inserted inside the outer cannula that allows you to keep the ventilator clean. We change this at least twice daily and clean it as needed in between.

For the most part, the Tracheostomy Ventilator doesn’t need to be changed unless something malfunctions. The two parts most likely to fail are the Cuff and the Cuff Balloon. The cuff holds the cannula in position and keeps the air from passing around it. If it gets a hole, it will not inflate properly. Since it sits in the esophagus, it is protected from accidental damage. The cuff balloon attached to a hose inflates/deflates the cuff. Since it sits outside the hose, it can easily get tangled up in clothing, bumped by caregivers hands, or shift for any number of other reasons. If damaged, it can cause the cuff to deflate.

So what does happen if the ventilator fails, you ask? Well, you can replace it at home or you can go to the ER. Oh yeah, before I forget an important step, you will need to manually ventilate until the vent is replaced. It isn't actually too difficult to replace at home, so should always have a spare at home, ready to go.

To help ensure the ventilator stays functioning, I get it replaced every 4380 hours. So far, every time I have had my ventilator changed, I go to Jiffy Lube (AKA the VA hospital). In and out in 20 minutes, and we're done. They even check under the hood. I got my vent changed last week and I asked if we could video the procedure. Like LeBron smacking the ball away, I was denied. I did get a quick picture, though.

Someone asked me once if it hurt getting the vent changed? The first time I had it changed was about three months after getting it. I didn’t know what to expect, so when it was removed I was a little shock by how fast it was. Since it was new my body was still healing inside the stoma and when it was removed it was still scabbing over. It felt like ripping off a scab that’s not ready to come off and yes it did bleed. The blood shot across the room hitting Laura right across her chest. It was like watching the tv show M*A*S*H when blood squirts on the doctor. The last thing I heard was CLAMP before I passed out. When I woke up it was done. Really quiet simple now that I think of it. Ok, it wasn’t that bad, but Laura passed out. I took it like a champ. To be perfectly honest, changing it out is quite simple and when the stoma is completely healed, there it a quick little sting and it’s over.

Did I ever tell you the story of when my arm was ripped off by a crocodile and I had to stitch it back on? No! I’ll save that for another time.

I can only hope this helped make you a little more comfortable when working with and changing the ventilator.

Love and Blessings 

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