How do you change the trach ties?

[Lifeisgood]

I'm just curious, I've always changed Harlie's trach ties while she's laying down. A few times lately, she wanted to sit up, so I changed them that way. Is this normal for when a child gets "older" (she's 21 months now)? I think the sitting up way is a little awkward for me now, but maybe with some practice it will get better.

How do you change them? Laying down or sitting up?

Thanks!
~Christy

[KJKK8437]

Sitting up, for about the last 3 months. But if I have to do it myself, I go back to laying down because I have more control over the child that way.

[TommysMommy]

A combination of both. We start out with him laying down to unfasten them and to wash and dry his neck. Then we sit him up to fasten them. That way I can see the back of his neck and make sure it looks okay and that the velcro isn't scraping him or his hair getting caught.

[faywrayy]

We do it like Rene...start off laying down to unfasten, clean, dry and insert new ties. Then sit her up to fasten, make sure her hair isn't caught or her n/g tube. Primary day nurse and I always change them together. On days I am alone, I do it alone with less squirming and issues than if the 2 of us do it together.

[alizesmom]

Alize: using chain, take off and clean while laying down, someone holds him in seated position to relatch.

Ciara: using trach ties, sitting up since she is much calmer this way.

I haven't decided if it's lack of guts or being wise but I would never change either one without a second person. Karen

[Topher's Mom]

I do everything sitting up. One of the RTs in the hospital actually did it with him sitting up one day because he didn't want to lie down. When we got him home, he just didn't want to lie down so I started doing it with him sitting up.
He is real good & usually sits pretty still while I do it.

Karol

[angelamclamb]

I have always done Jonathon's while he is lying down but he is on my lap. Like I sit indian style and his butt sits in the middle and drops down some ya know, his legs flug off to the other side so his shoulders are on my other leg so his neck is hyperextended and it makes it easier for me to change the ties. I cut his ties in advance to trim down the long velcro so when I have dried his neck (this is usually after a bath anyway) I then put one side of the ties in, (usually on the side closest to me), then I lift him up and with one hand hold his trach in place and the other hand I pull on the ties to get them to the other side (not pulling ties across the next or that would cause almost like a rug burn, pull them out and away from the neck) and then loop it through the other flange of the trach and velcro it. I think sit him up to check that I how many fingers I can get under the ties with his head tilted slightly forward, if more than one I tighten from behind. Then I lay him down flat in from of me and check to make sure the trach is midline by lifting it up a tad while I peak under to look at the angel of the inner cannula and adjust if needed.

I just like placing ties in one piece instead of two. Just hook, pull and hook. Then check tightness and if centered etc.

Not that you have to do this, but I have this need to kiss Jonathon's neck all over when I have those dang ties off!!! I cant wait until the days I can see a nekkid neck!!!

[drct1245]

We actually still do the trach ties when he is laying down b/c we still do trach care laying down and we change them at night time trach care. I did it while he was sitting in the high chair and I didn't like it. Ayden doesn't sit still, but he knows how to lay still for trach care.

[aydenava]

Always laying down ,much more control that way,when he was 1 1/2 we would were silly head things that lit up & stuff & he wouldnt be scared,& would stay still,(at that age he still turned blue & needed bagging,everytime he cryed),after about a year he would just be still.....Angie

[JWorthington]

We've always changed Sam's with him sitting up. In the early days he would sit on John's knee and I would clean and change. These days I frequently have to do them while he is standing in front of the tv! but we are old hat at it now

Juliexx