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View Full Version : first trach change tomorrow


joanne9
04-01-2009, 05:51 PM
Hello All,
I have to do my first trach change tomorrow, I observed last week, and have to do it myself in front of an ENT Dr in the morning, any tips? Im so nervous
Thankyou
Joanne

kirafaesmom
04-01-2009, 06:09 PM
I was really nervous too. Kira's only had her trach for 2 months, so the memory is still VERY fresh! I thought I was going to toss my cookies while I was waiting for our ENT (didn't help that he was 3 hours late!). As soon as we did the change, I thought "man....I was nervous about THIS???".....seriously, it's not nearly as bad as we think. I did a really good job of psyching myself out and didn't even need to. My advise is to just take a deep breathe...and then just do it. Pretty soon you'll be changing them without a second thought.

lynn
04-01-2009, 06:19 PM
The first time I changed Joseph's I wasa nervous wreck and shaking!- try to relax and take a second to get a breath, it doesn't need to be shoved back in the second it comes out. Watch for the breathing- when they take a breath, the stoma opens up and if you time it right, you can slide it it with the inhaled breath. I know it is nervewrecking- but it will soon be second nature. :whew:

babybear
04-01-2009, 08:18 PM
You'll be fine. I found that putting a rolled baby blanket under Gabriel's shoulders really helped.

Kaylie
04-01-2009, 09:27 PM
best of luck,, i hope things go well for you..

Gretchen(Celia's mom)
04-01-2009, 10:01 PM
:hug: You will do fine!!!!!

Andrew's Mommy
04-02-2009, 02:10 AM
You'll do fine. You got to do what you got to do! Good Luck

bryantem
04-02-2009, 02:18 AM
I never had to change it in front of an ENT. It is much more intimidating as it seems. I was more nervous to change the trach once we got home. I was just commenting to my husband how easy trach changes have become. I am at the point to where I am comfortable changing it alone, but I still wait for him to get home.
________
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Ainsley's Mom
04-02-2009, 03:35 AM
Breath. And it'll be over before you know it. You will do great. It's normal to be scared.

TommysDad
04-02-2009, 04:26 AM
For our first trache change, a nurse pulled it out, and we put it. Once my husband and I both felt comfortable in our rolls, the nurse and parents switched rolls. Then once the nurses felt like my husband and I both had the experience needed removing and inserting the trache with a nurse, they let us as mom & dad do our first trache change together as a family with no nurse involved. From that point on, my husband and I together always changed Tommy's trache together with no nurse involved. We did things like this for well over a year before my husband or I ever changed the trache by ourselves. We never had to change it in front of ENT, just nurses, and to do so infront of ENT after only observing, I'd be nervous, too!

We used the shoulder roll technique, too, to get that neck hyper-extended back farther so we could easily access the stoma, too. It helped a lot! And the inhaled/exhaled tip can help make things go smother, too.

Another tip someone shared with us was to put the velcro ties on the new trache before you start the trache change. That way once the trache change is over and the airway is secured, all you have to do is fasten the ties.

Our ENT & Pulmonologist never use the opturator. They say that's one more thing occluding the trache tube and they have seen parents & nurses forget to remove it when they are panicing. So, we never use ours.

There is one other thing I want to mention to you. I do not mention it to scare you, but just to educate you. No one ever told us the stoma could/would/might possibly ever clamp shut once until we witnessed it first hand ourselves:eek: . They just always said make sure you have the down sized trache available at all times. But if the stoma does clamp shut, wait a fraction of a second to see if, on the next inhaled breath, the stoma will relax and open up before reaching for that down sized trache. That waiting may seem like an eternity, but that little waiting has saved us from needing to use the down sized trache.

And I'm also trying to remember, when Tommy was so teeny-tiny, we might have swaddled him or done something to restrain his arms so he wasn't swatting at us while we were trying to do trache changes. But it's been so long ago I can't remember! I know as he got older, that would have only made him more frustrated and made trache changes harder for us. So as he got older and more aware, we always had a toy to dangle in his face to distract him or for him to play with while we did trache changes. Now my husband and I feel comfortable changing Tommy's trache by ourselves while Tommy sits up and watches his favorite television program. When it's all done and over with, Tommy claps.:hooray:

It seems very frightening when you have never done anything like this before in your life, but as parents, we all do what we must for our children. With time it just becomes part of your every day life and becomes quite natural believe it or not. Just keep a positive mental attitude and tell yourself if all of us on the trache forum can do it, so can I. You'll look back on this day and be so proud of how far you have come:D I know I do;)

~Maggie

JWorthington
04-02-2009, 07:49 AM
Just try and relax, take a deep breath, and try to remember that this is another step towards getting your little one home - hold that thought!
One tip we learned was to blow gently on his face to make him gasp - that opens up the stoma nicely. I'm sure you will do fine. Good luck, let us know how it goes

Julie

My little figther
04-02-2009, 09:28 AM
We were trained by the RT and nurses - the first time I was so shaky but I managed. I must admit my daughter is better at it than me - but it is OK granted we don't do it very often because Cedric is still at the rehabilitation center. I am sure you will get the hang of it in no time. Good luck
Michelle

Ainsley's Mom
04-02-2009, 03:15 PM
For our first trache change, a nurse pulled it out, and we put it. Once my husband and I both felt comfortable in our rolls, the nurse and parents switched rolls. Then once the nurses felt like my husband and I both had the experience needed removing and inserting the trache with a nurse, they let us as mom & dad do our first trache change together as a family with no nurse involved. From that point on, my husband and I together always changed Tommy's trache together with no nurse involved. We did things like this for well over a year before my husband or I ever changed the trache by ourselves. We never had to change it in front of ENT, just nurses, and to do so infront of ENT after only observing, I'd be nervous, too!

We used the shoulder roll technique, too, to get that neck hyper-extended back farther so we could easily access the stoma, too. It helped a lot! And the inhaled/exhaled tip can help make things go smother, too.

Another tip someone shared with us was to put the velcro ties on the new trache before you start the trache change. That way once the trache change is over and the airway is secured, all you have to do is fasten the ties.

Our ENT & Pulmonologist never use the opturator. They say that's one more thing occluding the trache tube and they have seen parents & nurses forget to remove it when they are panicing. So, we never use ours.

There is one other thing I want to mention to you. I do not mention it to scare you, but just to educate you. No one ever told us the stoma could/would/might possibly ever clamp shut once until we witnessed it first hand ourselves:eek: . They just always said make sure you have the down sized trache available at all times. But if the stoma does clamp shut, wait a fraction of a second to see if, on the next inhaled breath, the stoma will relax and open up before reaching for that down sized trache. That waiting may seem like an eternity, but that little waiting has saved us from needing to use the down sized trache.

And I'm also trying to remember, when Tommy was so teeny-tiny, we might have swaddled him or done something to restrain his arms so he wasn't swatting at us while we were trying to do trache changes. But it's been so long ago I can't remember! I know as he got older, that would have only made him more frustrated and made trache changes harder for us. So as he got older and more aware, we always had a toy to dangle in his face to distract him or for him to play with while we did trache changes. Now my husband and I feel comfortable changing Tommy's trache by ourselves while Tommy sits up and watches his favorite television program. When it's all done and over with, Tommy claps.:hooray:

It seems very frightening when you have never done anything like this before in your life, but as parents, we all do what we must for our children. With time it just becomes part of your every day life and becomes quite natural believe it or not. Just keep a positive mental attitude and tell yourself if all of us on the trache forum can do it, so can I. You'll look back on this day and be so proud of how far you have come:D I know I do;)

~Maggie

Yes, when we got Ainsley home we used a swaddler that velcro's closed. It was great for trach care and trach changes and I think she actually felt more secure. http://www.toysrus.com/product/index.jsp?productId=2265551

joanne9
04-02-2009, 06:10 PM
Thankyou All
I finally did it! It was scarey because of the ENT dr watching, but I found it quite easy, even easier than inserting the mini button, all being well Lauren will be allowed home on monday, then the hard work will begin! Thanks again for all your support
joanne

kirafaesmom
04-02-2009, 09:32 PM
Whoooohoooooo! Good job! I too found it much easier than replacing feeding tubes! That's great news that you will be headed home on Monday. You're right....it will be hard work, but oh SO worth it to be HOME!