Tracheostomy, Vents, Passy-Muir

Question 1

Tracheostomy

Answer 1

Surgery to create an opening in the trachea through the neck

Question 2

Reasons for pediatric trach

Answer 2

1. Syndromic

2. Trauma-related

Question 3

Endotracheal tube

Answer 3

Inserted through the mouth. Okay for short-term but typically uncomfortable and restrictive. Pt.s usually unconscious.

Question 4

Parts of a tracheostomy tube

Answer 4

1. Outer cannula
2. Inner cannula
3. Flange (secures trach around neck)
4. Obturator (only used during insertion)
5. Button/cap (used only with cuffless trach)
6. Cuff

Question 5

Possible complications of a trach

Answer 5

Granulomas, displacement, incorrect placement, bleeding, tracheal stenosis

Question 6

How to suction trach

Answer 6

1. insert tube without any pressure
2. When pulling up and out, create negative pressure by closing button with thumb (do not create negative pressure for more than 10-15 sec)
3. Rotate tube between thumb and finger as you remove it.

Question 7

Passy-Muir

Answer 7

One-way speaking valve for trach patients–allows air to enter but not exit. DO NOT USE ON CUFFED TRACHS

Question 8

Spontaneous ventilation

Answer 8

Natural breathing

Question 9

Manual ventilation

Answer 9

Gives breaths via AMBU bag through trach tube–often used after suctioning

Question 10

Mechanical ventilation

Answer 10

When person cannot breathe adequately. Uses positive and negative pressure to push air into and pull air out of the lungs.

Question 11

Control Mode ventilation

Answer 11

Breathing is solely through the vent–used in ALS patients and spinal cord injury patients

Question 12

Assist Control Mode ventilation

Answer 12

Full vent support but pt. can initiate extra breaths as needed w/machine assistance

Question 13

Intermittent Mandatory ventilation

Answer 13

Has preset rate/volume but patient can take extra breaths without machine assistance

Question 14

Synchronized intermittent mandatory ventilation

Answer 14

Same as IMV, but machine doesn’t provide an inhalation while pt. is taking an independent breath

Question 15

Pressure support

Answer 15

Pt. triggers vent by initiating a breath. Allows use of respiratory muscles without risking fatigue.

Question 16

Continuous Positive End Expiratory Pressure (CPAP)

Answer 16

Minimal support. Used during spontaneous breathing to overcome the work of breathing through the vent.