What do you do to hold up vent tubing?

[FightingForFaith]

Hey guys- this kinda goes with my other post on the ped. thread- Faith's stoma has been stretching and I'm thinking it's from the weight of her vent tubing pulling down on the trach. We use a restraint from the hospital anchored with blue hemostats to keep it from pulling. Sometimes I feel like this does not make a difference. What do you guys use if anything at all? I've attached a picture showing what we do- except in this pic there is a little yellow clothes pin holding it up instead of the hemostats.

[TommysDad]

We used to use a velcro strap that we got at the hospital that had a clip on the end of it. Neotech sells them, and they will send out samples. It is very similar to what you are using. One thing that we did differently was to loop it around one of the legs of the "Y" which would hold it up more. Lately, we have not been finding that we use it as often (I am not sure why we stopped). After Tommy's first stage of his LTP, his stoma is huge already, so I hope we do not get any stretching. Although, with 18 months of being on a vent, his stoma was very tight prior to the LTP.

[T-bone]

When Abby was a baby we used the disposable tubing. It is much lighter. Now that she is older (7) we use the perm tubing.

I love, love, love her glasses. Super cute.

Tess

[Mom2TwinsPlus1]

We used to use coban to secure it in a few places to her crib at night, but now we dont use anything it just kind of hangs from her bed rail and for some reason seems to work for us. In her chair we kind of tuck it around a few spots and it holds pretty well.

I think the coban worked great, and we tried zipties but I didnt much care for them either

[Alex's mom]

We use the hemostats and the velcro clips that tommysdad was talking about. We usually attach the straps a little lower on the tubes and allow some slack before clipping it to her shirt or pants.

[tranorris]

Im an adult but When im on the vent only at night i have a tie that comes in my trach kit and tie it to a clippy thing and on my sheet we attach it. That way it doesnt pull on me. We drape the tubing down where about my wrists are and my water trap cup hangs down. It works pretty good. Every nite the nurses move it cuz i guess i dont lie in the same spot every nite. I tell them they have to earn there pay somehow cuz they dont have to do much of anything else lol

[kshell]

I'm actually curious about this too. Natalie's d/c is scheduled for early June (praying all goes smoothly). And I feel that since she was switched to the LTV the tubing really weighs her down and almost restricts movement of her left arm (thank goodness she sucks are right thumb!!). I heard there is smaller circut tubing, but nobody from respitory seems to be able to produce any. Is there really such a thing? Right now they say that her circut is between a peds and adult size.

Thanks,
Karen

[lil' G's mom]

I heard there is smaller circut tubing, but nobody from respitory seems to be able to produce any. Is there really such a thing? Right now they say that her circut is between a peds and adult size.

Thanks,
Karen


Karen, Yes there is a smaller neonatal size, we went thru that when they transfered us to a differet hospital, but I fought until they special ordered for Geoffrey. I felt the larger was to big and pulled to much on his trach. Just keep bothering every person you see till they do it, thats what I did:p

[T-bone]

http://www.ventilatordistributor.com/images/11833b.gifThis is a pic of the peds tubing. Like I said it is disposable. Check out http://www.ventilatordistributor.com/pages/circuits.htm
You should be able to find the product number. Then order it from your DME.

[FightingForFaith]

Thanks for posting that pic and link Tess. That looks like the our portable circuit (we have an 850 FP heater which requires a diff. circuit for travel....what a pain...) but the current circuit we use on a day to day basis restricts Faith's left arm too. Her OT and PT gets really frustrated with the tubing. I'm wondering if Faith is too big to have the neonate circuit (she's about 20 pounds...) we asked for longer tubing so the Y part could be down near her bottom, thus making it easier for her arms to move but her pulm. didn't like that idea (he thought there would be too much CO2 build up...) Hmmm...
Hey I have another question for ya- how often do you guys change the swivel adaptor? In the hospital we were told to change this every other week with the circuit change but our home care nurses said it should be changed daily. Hmm... Also what's up with the pokey things? Faith doesn't have much of a neck so we always have to cut them off.

[T-bone]

Not sure what the "pokey" things are that you are referring to. hmmmm

We change the swivel thingamajigy when we change the circuit. Sometimes Abby's can get grungy if she coughs something into it, then we will change it.

Yes, I have heard about the build up of CO2 if there is too much "dead space" on the tubing.

Tess

[drct1245]

We tied twill tape around around his neck and then as he got older we would tie another twill tape lower and clip it to his pants or shirt.

We change the swivel (you are talking about the one that connects to the trach -?-) every week. We would just soak it in 1/2 vinegar and water each week and reuse b/c we didn't get that many (they were actually contraband one of the RTs got from a hospital from she worked at.) If Ayden gets sick then we clean it every day.

We used the travel vent and a HME for every use when we weren't in his room. Then the vent in his room had the humidifier.

hope that helps a little.

[twintotwin]

We used Poseys or the plastic baby links (the toy links)...usually the toy links since you could hang toys and bolus a feeding if you're really talented.

[TommysDad]

Tommy's elbow/swivel USUALLY gets changed with his circuit. Our RT at Chicago's hopsital says once a month. Home RT through DME company says once a week. I don't remember what Ohio recommended--once every 2 weeks:confused: Yet Tommy only gets 4 circuits a month, and he uses his back up vent each and every day as his "portable vent". However, Tommy is also trying tastes, and a lot of times those tastes end up in his elbow/swivel adaptor, and we have to change that part more often. Yet we only get 6 swivels per month. And YES...we understand those pokey things you are talking about on those particular swivel adaptors. They are awful! I think the pokey parts are ment to help hold a securement device (twill tape/rubber band, etc.) to the elbow, back behind the neck and back to the other side of the other pokey part. Ohio uses those swivel/elbows, and we always pack our own!!! Our are INTERSURGICAL. The package has stamped: "1994-3-A DOUBLE SWIVEL ELBOW. ISO PUSH AND TWIST CONNECTION". Want us to send you one to try? If you like ours better, maybe your DME can special order you them? I would think that even after you cut those pokey things off, you'd have a very rough edge that would need to be filed. Maybe they are great if you actually have a neck, but what baby does?!?
~Maggie

[TommysDad]

I wanted to comment on the ventilator tubing questions. The tubing in the picture is actually a larger diameter than Tommy's. This is also another issue when we got to Cincinnati. I will grab a part number off of his (or Maggie might do it before I get to it). Currently, we are using the heated (blue) circuit on both his portable and stationary vent, but I have a non heated (white/clear) that I am going to try. If the weight of the tubing is really an issue, there is one other thing that you can try. First, you do not know where you heard this from :). You will need to find someone to work with (maybe your home RT) to get their blessing on it and work with you to get the right parts. For Tommyy's circuit, we take out the 24" peice of white tubing between the exhelation or peep valve. We attach the valve directly to the "Y" with a rubber or plastic adaptor (both work equally well). We then use o2 pressure line to extend the thin hosing on the peep/exhelation valve with a 4.5mm connector (good luck getting those, it took us a while). This gives some freedom and a lot less weight. The downside is that codensation does accumulate in the "Y" if you are not carefull, as it does not have the opportunity to drain into the white unheated line. The RT in Chicago sent us home with this setup and we have been using it ever since. When we get admitted to Cincinnati, it is the first thing they change.

Another change that the RT in Chicago set us up with is a change to the filter setup. Rather than using the tubing that comes with the circuit to connect between the vent and the heater chamber, or the vent->filter->circuit when not using the heater chamber, we use two segments of larger tubing and a connector similar to the one that comes with the circuit that goes into the ventilator. One segment connects to the ventilator with the connector that comes with the circuit. The other segment goes onto the filter and then the connector goes to either the segment of tubing going to the heater chamber or to the circuit itself if you are not using a heater. The downside is that this adds to the monthly order, and when you are portable, you do need to watch for kinks in the tubing. The plus side is that you are less likeley to hit the filter against something and crack it and it is a little more compact. I am torn on it because the tubing does line up better without this setup, plus I am able to just take the circuit out of the bag and extend the peep valve as opposed to grabbing another connector and cutting two lengths of tubing, but when I have tried it portable with just the filter, it does not fit in the car as niceley and we need to put it in the stroller sideways.