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View Full Version : Capping and illness


Big Al
04-24-2009, 08:00 AM
Hi all thanks for the replies to my pmv question. I thought I dip into the think tank and see if anyone else has had this issue. My little guy S is starting to get capped durring the day, but it seems that every time we get to around four hours he gets sick. Its like clock work it sets him back and we loose a lot of our progress. Has any one else he'd this problem? I think I'm crazy parhapse the two arnt related but this is the third time it happened.

JWorthington
04-24-2009, 12:42 PM
Hi Al
I'm not sure how it is with your little charge, but this is what happened with us. (over 4 years ago now, when the trach was only 'temporary')
3 different nurses tried to tape up Sam's stoma, they all got pretty close and at least one of them had a cold - 3 days later Sam had a nasty infection which turned into pneumonia resulting in another month in hospital, O2 and a permanent trach (while needing O2). Is anyone around S ill? I'm sure you are not the only person caring for him. Make sure everyone around him is being meticulous with hygiene before trying to cap off the trach - alcogel, gloves, whatever is necessary (though I'm sure you do) I would also suggest suctioning to clear out any nasties before trying to cap - anything festering in there could soon cause problems.
Don't know if this helps, it's just the way I see it. good luck! :)

Julie

Ainsley's Mom
04-24-2009, 01:38 PM
I got on the board today to ask a question about sickness and capping and thought you were going to ask the same question. It is interesting. While one would tend to think it's a coincidence I think Julie raises a good point in that once the cap is on then there isn't airflow through the cannula. So maybe germs can grow in that environment and when the cap is removed they are pushed down into the airway. I wonder if doing a good suctioning with saline prior to capping might make a difference.

Big Al
04-25-2009, 12:36 PM
I had the same thought about the junk left to fester. I talked to the nurses at day care they suction him before and after they cap. As for hygine S lives in a large house with other kids the house is a mess at all times so hygine is a huge issue with him. I thnk I'll talk with mom because when I com in at night I'm finding lots of junk an having trouble with mucious plugs I think she doesn't hear that he needs suctioned when his cap or pmv on. So the junk just sits.

Ainsley's Mom
04-25-2009, 12:46 PM
I had the same thought about the junk left to fester. I talked to the nurses at day care they suction him before and after they cap. As for hygine S lives in a large house with other kids the house is a mess at all times so hygine is a huge issue with him. I thnk I'll talk with mom because when I com in at night I'm finding lots of junk an having trouble with mucious plugs I think she doesn't hear that he needs suctioned when his cap or pmv on. So the junk just sits.

Generally we don't need to suction while wearing the PMV and not the cap. If there is enough pressure and airflow the secretions generally push up into the mouth to be swallowed while wearing the PMV and Cap. Occasionally if Ainsley is having trouble and coughing with the PMV I'll take it off and suction but I prefer that she handle it on her own because that is training for the eventual step of decannulation.

Although if you're saying there are issues with plugs, perhaps he needs some more moisture. Perhaps some saline throughout the day. Or build in a suctioning schedule? Such as check him for suctioning every 2 hours whether he seems to need it or not. Also as a nurse recently pointed out to me. Kids get normal humidification while wearing their cap since the air is coming through the nose and mouth. It's really when wearing the PMV that they can need additional moisture. Good luck figuring it out.