Trach Change Question

Babystone06 · #1 12-17-2008, 07:30 AM

My daughter is being cared for at a home like nursing facility. She got out of the hospital in April after being in there for 15 months. We are bringing her home for christmas eve/ christmas day so I had to go for trach training. I just found out from her nurse that our daughter has been using the same trach tube since april. They never ordered her new trachs so they have been just washing the two she had in soap and water and vinegar. I am so outraged! The doctor ordered her trach to be changed weekly. I'm sure he expected new trachs to be used instead of cleaned ones. The nurse informed me that they really can't get all of the trach cleaned (she has a bivona ten trach) and showed me that part that has build up in it.

My question is, is it normal not to use new trachs? Even after she has been sick? And for that long of a period?

Ann Marie

Kate · #2 12-17-2008, 07:53 AM

Everyone is different. We re-use trachs (as I know many here do) IF I have a plether of trachs...which sometimes I do...then I use new ones. OR-if he has had a bad infection. We were told that we could re-use the trach until the lettering started to rub off...then it was time to get a new one. But, like I said-if he has a bad infection, then I get a new one and throw the old.

We wash ours in 1/2 peroxide and 1/2 sterile water. I use a pipe-cleaner to get the inside. If they could get those kits-those are handy to clean trachs too. We use Shileys so I'm not sure what is common for the brand you use.

BUT-they probably should have new ones since April. Thats 9 months of using the same one. The nurses probably should've called and asked you or the drs.

Mom2TwinsPlus1 · #3 12-17-2008, 07:54 AM

We do weekly changes but only get 1 trach a month so yes we clean and reuse. I have trachs I know are over a year old maybe more, I always forget to reorder new ones! But if there is still build up in yours I would be concerned. That gunk can cause bacteria to grow. We uses shiley trachs and soak ours in peroxide and sterile water, if I am out of peroxide I will use vinegar but I find that it doesn't work well at all for getting gunk out. We also use the kits that have the little brush and pipe cleaners. Pipe cleaners work wonders on getting gunk out

There are lots of ways to clean and sterilize a trach, so hopefully you will get some helpful answers here.

We do not do ours as a sterile procedure, ie we don't wear gloves and use a sterile cloth to lay them on, just clean hands. Our doctor told us once a trach is opened it can never truly be sterilzed again, atleast not in a home setting. That has always worked for us, but each child is diffrent.

faywrayy · #4 12-17-2008, 08:33 AM

Kate had Bivona trachs for the entire time she had a trach. In the time -- 19 1/2 mos -- she had a total of maybe 7 trachs. We re-used the entire time and with no issues. We didn't have trach cleaning kits (didn't even know they existed until earlier this year), but I washed them well in soapy water, rinsed well and they plopped in boiling water, let it go in there for 10 minutes, then turned off the heat and left it there for 30 minutes. I let them air dry until completely dry, then wrapped in paper towel and put in plastic bag. She didn't have any issues. Her ENT (at CHOP) told us we could re use indefinitely. Kate's trach was changed weekly.

I don't think it's a real issue that she's been using the same trachs, but it sure would have been better if you'd known about it and could have discussed it with her doc.

Melisande · #5 12-17-2008, 09:58 AM

We reused our Bivona flextend trachs, which we had 3 of, for well over a year. They are good until they start to break, usually around the metal coils in the flextend part. Anyway, they do need to take the plastic off around the shaft (or whatever that part is called, the hard plastic part). It can be removed with the forked prong that comes with the trach. You have to squeeze the end of the trach because there is a lip that holds the plastic piece on so that the plastic piece can slide off. This isn't the easiest thing to do, but it can be done. I soaked our trachs in vinegar for about 30 minutes. Then, I boil water for 20 minutes and then let the trachs soak in the freshly boiled water for 20 minutes. Then, I dry them with the sterile supplies from a trach cleaning kit. I set them on the sterile buckets to air dry. I have plastic cups I put our trachs in. They are actually specimen cups with holes poked in the top. I sterilize them too along with the trachs. This has worked for us for over 5 years. We were taught to do this at the hospital oh-so-long ago. Clearly, this is okay with our ENT.

Oh, we change trachs weekly in rotation.

KJKK8437 · #6 12-17-2008, 10:32 AM

Last time we were in the hospital, they sent Alex's Bivona down to be cleaned. For the first time, they failed to take the swivel off, and they just cleaned and sterilized it with the swivel on. There was junk underneath the swivel that may have been "sterilized" but it certainly wasn't clean.

We used to re-use trachs all the time. We have a back log of new ones right now, so we aren't re-using them so much, but we still do.

Anyway, it is worth it to make sure that when the nurses are cleaning the trachs, they are removing the swivel.

(If you don't know what I mean, let me know. There is another thread that shows the swivel and how to take it off.)

Alex's mom · #7 12-17-2008, 11:58 AM

We have bivonas and we re-use. We wash them with soap and water and then sit in water that has been boiled. Sit it out to dry completely and then store in a ziplock bag.

There should never be buildup - that is a trach that wasn't cleaned thoroughly. I don't have trach cleaning kits or pipe cleaners but we use the obturator to clean out the inside of the trach tube - if there is something in there that is stubborn and won't come out easily then I sit it in hot water and try again later.

We get one new trach a month and we change her trach weekly. I usually rotate the new ones in and get rid of others as they get old.

Babystone06 · #8 12-17-2008, 02:48 PM

Thank you for all your answers! I did confront a different nurse today and she told me that my daughter should have gotten new trachs. She said Medicaid cut back on giving new ones. I informed her my daughter has blue cross and they should cover it. She should at least get a new one every month. I will confront her case manager and see why they never ordered a new one for her.

Thanks again!