Nighttime suggestions

LVMom23 · #1 08-07-2010, 04:26 PM

Hannah has had her trach now for about two months now, one month out of the hospital.

She uses a humidified trach collar at night along with a humidifier next to her crib. I keep making sure the trach collar is over her trach until I fall asleep around 1 am or 2 am. Then, when she wakes up around 5 am or 6 am (still working to get her on a normal night schedule), she wakes up really dry and we usually have to give her a saline nebulizer treatment or saline drops & suctioning to clear her out. She was even plugged once.

We live in Vegas now, where it is really dry out here. But we thought with the trach collar and the humidifier next to her crib, we would be okay.

However, if she moves and the trach collar moves away, she gets dry pretty quicky it seems, within a matter of a few hours.

Does anyone have any suggestions on how to keep her "moist" during the night?

LKN · #2 08-07-2010, 07:58 PM

How old is she? Is she very wiggly while she sleeps?

We used to switch out the green elastic on the humidifier mask with velcro trach ties. We found that the velcro trach ties really held the humidifier mask/collar in place better so more humidity was directed down the trach. You have to be careful if you try this out--make sure she doesn't pull on the trach mask and accidentally decannulate in her sleep. Apparently some kids do that. This never happened to our son in the 3 1/2 years he was trached, though.

Kate · #3 08-07-2010, 09:02 PM

Quote:

Originally Posted by LKN

How old is she? Is she very wiggly while she sleeps?

We used to switch out the green elastic on the humidifier mask with velcro trach ties. We found that the velcro trach ties really held the humidifier mask/collar in place better so more humidity was directed down the trach. You have to be careful if you try this out--make sure she doesn't pull on the trach mask and accidentally decannulate in her sleep. Apparently some kids do that. This never happened to our son in the 3 1/2 years he was trached, though.

That's a great idea!

Thanks!! W/Mitchell's new t-tube we're going to probably need mist at night and thanks you just gave me a great idea

I love this board!

lynn · #4 08-07-2010, 10:21 PM

Quote:

Originally Posted by LKN

How old is she? Is she very wiggly while she sleeps?

We used to switch out the green elastic on the humidifier mask with velcro trach ties. We found that the velcro trach ties really held the humidifier mask/collar in place better so more humidity was directed down the trach. You have to be careful if you try this out--make sure she doesn't pull on the trach mask and accidentally decannulate in her sleep. Apparently some kids do that. This never happened to our son in the 3 1/2 years he was trached, though.

Thanks for the idea!! Joseph is on the vent/humidifier now, but after all surgery is done we are talking weaning vent use at night too.. he absolutely HATED the trach mask because of the green elastic..(our last stay, they tried him on it during day, cause the hme seemed like it wasnt working well enough- only lasted minutes with the fit he had. ) I will have to remember this for when the time comes.

LVMom23 · #5 08-07-2010, 11:53 PM

She just turned two, and she is definitely a wiggler -- we found her, mask off, at the end of her crib, sideways, the other night!

I will have to play with the velcro idea, that makes a lot of sense!!

Quote:

Originally Posted by LKN

How old is she? Is she very wiggly while she sleeps?

twintotwin · #6 08-08-2010, 08:42 AM

Quote:

Originally Posted by LVMom23

Hannah has had her trach now for about two months now, one month out of the hospital.

She uses a humidified trach collar at night along with a humidifier next to her crib. I keep making sure the trach collar is over her trach until I fall asleep around 1 am or 2 am. Then, when she wakes up around 5 am or 6 am (still working to get her on a normal night schedule), she wakes up really dry and we usually have to give her a saline nebulizer treatment or saline drops & suctioning to clear her out. She was even plugged once.

We live in Vegas now, where it is really dry out here. But we thought with the trach collar and the humidifier next to her crib, we would be okay.

However, if she moves and the trach collar moves away, she gets dry pretty quicky it seems, within a matter of a few hours.

Does anyone have any suggestions on how to keep her "moist" during the night?

Great idea with the trach ties, Kristy!

Be very careful using an additional humidifier. They can spread bacteria and mold throughout the room if you don't clean it every single day and use sterile water. In fact, we were told not to use one- I think a lot of pulms recommend not using one. (of course we tried it anyway, the boys were sick pretty often during that time, could be coincidence)

Maybe try adding a half bullet of saline every couple of hours. Can you get a night nurse? Since it's very dry there, give her the saline and more water orally/GT before bed too.

It's such a tricky balance between keeping it moist but not sticky (too wet). Good luck!

Corinne's Mom · #7 08-08-2010, 09:41 PM

Corinne ran into this issue too. We would tighten her trach ties and then attach a second set of trach ties to the humidification line (attaching on the right always, as not to accidentally undoing her actual trach ties). I would still be running down the hall with her between 3-5 am with her almost occluded in her trach due to drying out. The other mommy is right, the key to maintaining loose secretions is hydration. Contact several nutritionist and find out your kiddo's require minimum and max hydration intake daily. We were also told that the heated line humidifier would give her the best hydration, not for Corinne, who often writes her own book. A cool mist humidifier set up with an air compressor worked best for her. Try to avoid that additional external humidifier as it will create more bacteria than help. I know of other measures other moms have used like a heater with the air compressor, but the air compressor worked best for Corinne. I wish you well, you are doing a great job at being an amazing mother.

faywrayy · #8 08-10-2010, 08:08 PM

We used the fastener that came with the trach mask, but instead of snapping both sides, we snapped one and then put it on and tied the other one, so we could make it fit tighter and more flush to her neck. That worked well for us.

Also, how about those velcro straps used with some apnea monitors - maybe you could use them to strap the tubing to her torso????

madelyn and rynns mom · #9 08-10-2010, 09:16 PM

We use a Fisher Paykel DirectConnect Tracheostomy Interface. Does great for Maddy. We had that same problem with the collars. We did add a few drops of a saline bullet to her a couple times a night when we used the collar. That helped. We found out about the direct connects at the last trach conference. Love them.

Kris

DAELOVIC · #10 08-11-2010, 04:54 AM

Hi, we are having same problem here.. Madrid is really dry + my son is only 3.8kg (4 months c age) and we don't find a proper trach mask for him (it should be neonatal, pediatric ones are so big for him...). We are trying with not too much success a HME with o2 port (intersurgical) (as the Thermovent T) + a humidifier. HME is to big for him as well and he keeps taking it off the trach.. he desat and we have to put it on again every 30 min. There`s been some nights that we had to end up using our bathroom shower too have quick humidity for being able to suction him properly. We are really having a nightmare every night.
Anyone of u knows if exists where to find a trach mask for his size (neonatal)? txs