With age, the body starts to degenerate. It is not just true for major organs but can also be applied to as simple as the trachea or what we call the windpipe. The condition that affects the windpipe can be dealt with by a procedure called Tracheostomy. When it is a removal of the tube, then it is called Decannulation in tracheostomy.
We are sure you are confused regarding what is Decannulation in tracheostomy. We will be answering all your questions here. Meanwhile, if you wish to drop your query for a treatment, just send your queries here!
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What is a tracheostomy?
You must have seen an opening in the neck and a pipe inserted in many patients. Ever wondered what that is for? That is a pipe and the particular procedure of inserting that pipe is tracheostomy.
A tracheostomy is a way created in the front of the neck. This is done so that a tube can be inserted into the windpipe also called the trachea to help you breathe. If necessary, the tube can be connected to an oxygen supply and a breathing machine called a ventilator.
What Do You Mean by Decannulation in Tracheostomy?
When the patient no more needs the tube in the trachea is when the process of Decannulation in Tracheostomy takes place. It can be defined as the process of removing the tracheostomy tube is removed once the patient no longer needs it.
What are the requirements for Decannulation in Tracheostomy?
You must be wondering, why a patient might go through Decannulation in Tracheostomy, how would it affect them, or is safe. Hence, to get all your doubts answered we have the requirements here:
Patients should not be dependent on a ventilator, and their mental status should be to the level of alert and responsive and should be able to manage their oral secretions without risk of aspiration.
The requirement of frequent suctioning for tracheal secretions should not be present. They should be able to cough and clean his/ her tracheal secretions.
The patient should have their tracheostomy tube downsized to a size 4 Shiley or similar tracheostomy tube and they should not have breathing difficulty in the presence of this tube.
The Shiley or similar tube should be occluded (with a trach plug/ cork) for twelve hours during the day with close monitoring by the nursing staff with no evidence of respiratory difficulty or requiring suctioning of the trach tube.
Once the patient is seen to tolerate the above, their trach is plugged for twenty-four hours and they are monitored for respiratory difficulty or suction requirement.
What is the procedure for Decannulation in Tracheostomy?
Decannulation is a two- to three-day process and is done in the pediatric intensive care unit in the hospital.
The tube is capped overnight:
During the first night, the tracheostomy tube is kept capped while the child sleeps. Heart rate, respiratory rate, and oxygen levels are closely monitored. The ICU team also assesses for restlessness, diaphoresis, and the ability to clear secretions without removing the cap to suction the tracheostomy tube.
The tube is removed:
If the child has no difficulties with the overnight capping trial, then the tracheostomy tube is removed the following day by the ENT team. The stoma is covered with a small occlusive dressing. Observation continues for another 24 to 48 hours to make sure that the child is able to breathe comfortably without the trach tube when awake and asleep, and is able to cough and clear respiratory secretions adequately.
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Is Decannulation in Tracheostomy done at home?
No. Given the complexity of the condition and the process, you cannot get it done at home. You must take an appointment for the same!
What is the purpose of Decannulation?
The basic purpose is the removal of the tracheostomy tube. It is best performed as a multidisciplinary team effort in which many medical staffs such as respiratory care practitioners, speech-language pathologists, and nurses, with the physician are consulted before there is any decision made.
What are long-term tracheostomies?
A non-weanable and the one which cannot be removed is known as long-term tracheostomies. The two common conditions that most of ENT will look after in such a case are:
Suprastomal granulation tissue or slight anterior tracheal wall collapse is present in many instances. This can partially obstruct the airway without the tracheostomy tube in place.
Someone with a tracheostomy will sometimes have large tonsils and/or adenoids. This condition can cause airway obstruction during sleep after the tracheostomy tube is removed.
What might be the tracheostomy recovery time?
After surgery, the neck will feel a little sore. Patients experience trouble swallowing for a few days, which is also one of the steps of the healing process. It may take 2 to 3 days to get used to breathing through the tracheostomy (trach) tube. You can expect to feel better each day.
What is the cost of Decannulation in Tracheostomy?
The cost of Decannulation in Tracheostomy can be very high in other countries but in India, it starts from about $1,000 and can be higher compared to what kind of hospital & condition of the patient.
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