Suctioning and things

[JWorthington]

Sam is 23 months and home from hospital 3 months after his trachy was put in. He coughs a lot atnight, sometimes really badly - probably about once an hor, but not much in the way of secretions sometimes. We go through between 7 and 20 catheters a night.
We wondered if this was normal for children with trachys and if anyone could share their experience of suctioning frequency and/or whether frequent coughing fits are normal or not.

Thanks, John and Julie (and Sam!).

[Stefan & Jennifer]

Our son didn't sleep through the night without coughing until he was over a year old. When he's sick he still coughs a lot at night without waking up. I agree that you shouldn't suction every time unless the secretions are not coming up to be wiped away or sucked away with a bulb syringe.

Considering the trach has only been in for 3 months, I think what you are going through is pretty normal. We used to go through 10-15 suction catheters a day for the first few months and now we're down to about 4-6 a day when Jake is relatively healthy.

[Jacob's Mom]

Our son required very frequent suctioning for the first 6-8 months after he got his trach (he was 5 wks old at that time). I mean sometimes every 2 or 3 minutes and up to 75 times a day. But he has never required much suctioning during the night. Usually only when he is sick will we have to suction a few times during the night. Since he was put on the vent at 11 months, I can probably count on one hand the number of nights during which he has needed to be suctioned. Every child is different and unfortunately the frequency of suctioning is no exception to that rule.

[Whitney]

When we first brought Alex home from the hospital, we would suction him every 2-4 hours generally. When he was sick, he needed suctioning more frequently (every 30 min to an hour). Now, we suction him 3-5 times a day. His secretions are minimal now. It is very dry here (Colorado). He only gets a lot of secretions immediately after we take him off the mist collar. We are thinking about getting rid of that contraption and just using an HME along with a humidifier. Alex's diuretics also changed his secretions. We could always tell he was ready to wean down his Lasix and Aldactazide when he would get dry. I hope this helps a little.

Whitney

[Judy]

Kenya's suctioning needs vary. We may suction every hour or we may suction 6 times a day. When she has a cold, the need is greater.

I have been reading where many of you talk of having to use the Saline to keep them from drying out. We do use Saline occasionally for suctioning but not often since she is on the heated MOIST oxygen. Do most of you use the Fisher Perkal
to keep the oxygen moist?

I know that when Kenya is off that she is much to dry.

I am so excited for all of you who are looking forward to decannulation in the near or even distant future. We found out last week, what we probably already knew but did not admit, that Kenya will probably ALWAYS be on the Trach.
I was not as upset as I thought I would be. I looked at our little miracle and realized that without the trach we would not have her so if she needs it forever that is fine. We can all live with that. Just as long as we have Kenya with us.

Hope you all get to experience a much healthier new year in 2005. http://www.tracheostomy.com/iB_html/non-cgi/emoticons/inlove.gif

[Alethia]

Hi there.

My little boy,6 months, needs suctioning every 2-3 hours, but usually several passes are needed at each "session". He doesn't produce copious gunk, it's just appallingly sticky, despite saline nebs 4 times a day. He's on a ventilator and has a portavent humidity exchanger but his stuff is just thick. I don't suction him when he coughs, I suction him when he shows other signs of having probs with breathing. He's usually very smily and happy, but he gets sort of restless and dissatisfied and his sats sit in the low 90's when he needs to be suctioned. If he didn't have the sats monitor I would still know because I go more by how he's breathing and behaving.

Regards,

Kate

[Olga]

Grace needed loads of suction when she was first trached - every few minutes when she was awake. Some children are on medication to reduce their secretions, but I'm not sure this medication is widely used in England. We were never offered it. Grace was 9 weeks old when she was trached so didn't have a very strong cough. When she was asleep she needed suctioning about every 2 - 3 hours. By the time she was a year old she was going all night with needing suction. As she grew older the need for suction lessened considerably.

You have to rember that a trachy is a foreign body in the airway and will therefore cause some irritation. Until the airway is used to this then there will be a lot more mucous production. That is why it does get easier.

Perhaps it might be an idea to either raise the head end of his cot/bed or prop him up on a pillow to try and reduce the coughing at night.

Good luck
Olga