Vent pulling and accidental decannulation

[Alethia]

Hi guys. Any hints? Angus keeps pulling on his vent hose and has decannulated himself once and managed to get his trach tube lodged diagonally across his trachea another time. Despite the fact that this was very uncomfortable for him (and stressful for the grown ups around him!) he's still doing it. I've tried doing his tapes up tighter, but then his skin starts to break down within 24 hours under the flanges. If I pad the flanges with Melolite, it masks how far his trach tube has come out (it took the nurses a wee while to realise he'd decannulated himself when that happened because of the Melolite), even though it does allow the skin to heal.

I don't even think he's doing it for attention, because he'll do it even when you're cuddling and playing with him, and when he's perfectly happy out and about in his buggy. We've been very careful not to react emotionally when he's done it. We just put the hose back on (and his trachy tube back in!) quickly and quietly. Admittedly I don't know how the nurses are dealing with it when we're not there, but I'd like to think that they know from past epxerience with kids like Angus, not to over-react. What can we do other than what we're doing?

Love,

Kate

[Melisande]

It could be that he may need a longer trach tube. That helps. Also we use a Bivona flextend, which has an extender piece on the cannula. It gives a lot of flexibility to the vent connection. Also, we use an accordian-like extender on the vent circuit and a swivle adapter. He still decannulates sometimes even with that all. When they're mobile, it's hard to keep it from happening. http://www.tracheostomy.com/iB_html/non-cgi/emoticons/partytime.gif

[menna'smom]

agree with above, very hard to keep from happening when your kid starts to get more active.

for us, the trick was going to a longer tube, when menna had neo size, she would have terrible decannulations quite frequently while on the vent (just flipping over at night), and even some off vent. we haven't had a decan since switching to the peds.

sebby

[Alethia]

Thanks for the suggestions. http://www.tracheostomy.com/iB_html/non-cgi/emoticons/smile.gif Angus has a 4mm Ped Bivona, so I don't think we could get it longer http://www.tracheostomy.com/iB_html/non-cgi/emoticons/sad.gif . It looked really sore when it was wedged in diagonally - I was just so relieved it wasn't a rigid Portex otherwise I think it could have done him some damage! He has a swivel connector, but just a standard vent hose with a y-piece.

I've had a look at the flextends and I think they look great, but one of the nurses was saying that they kink a lot and don't provide a very stable connection. Has this been your experience with them? I didn't ask about getting one for Angus when she said this, but I wouldn't mind hearing from other parents what they think about them for active, stubborn, single-minded little bubs!

Love,

Kate

[Melisande]

Never had problems with kinking. The extender is well reinforced with wire. If you have an MRI done, you have to switch trachs.

[Alethia]

" If you have an MRI done, you have to switch trachs"

Forgive my ignorance, but what do you mean? An MRI as in MRI scan? I'm not up to date with all the trach abbreviations

[Bridgie'smom]

Yep, that's an MRI scan. The Bivona trach has metal in it, unlike Shiley's. Not something you want flying out during a scan--yikes!

Theresa

[TeraNicole]

We also use the Bivona Flextends and I dont think this trach can kink. Maybe your nurses are thinking of another trach. This trach is very well inforced with wire inside. If you want pics, they are on Zachary's website.. www.zacharybeachley.com

We also use a swivel adapter as well.