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Post-Tracheostomy Tube Management Essay

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Post-tracheostomy tube management has traditionally been managed by the surgery service. However, it has been questioned whether or not an advanced practitioner is able to safely change a TT. Therefore this retrospective study was completed to assess the SLP’s success with changing TT in the acute care setting with physician support as needed.

Our retrospective study revealed 107 TT change procedures that were initiated under the supervision of a SLP. A total of 106 (99%) of the referrals successfully underwent a TT change without complications under the supervision of the SLP without physician intervention. One (1%) of the procedures was aborted secondary to a complication with the attempt to remove the TT through the stoma. This patient …show more content…
Complications rates are reported to be 2.1-20% and include the potential for airway loss and extratracheal tube placement resulting in subcutaneous emphysema, pneumomediastinum, and cardiac arrest or death. (Schmidt, Hess, Kwo, Lagambina, Gettings, Khandwala, 2008; Fikkers, Briede, Verwiel, Van Den Hoogen, 2002; Ritter, Lakshmanan, Sakabu, Troop, Trottier, 2002). Premature changing a TT tube prior to maturation of the tract increases the potential for complications (Deutsch, 1998). Our findings indicated the TT change procedure were completed a mean of 13 days post tracheotomy which is consistent with The American Academy of Otolaryngology-Head and Neck Surgery Foundation (White, Kher, & O'Connor, H. 2010) and other publications (Resp care 2013). No loss of airway, death, malpositioned tube was reported with any of the TT changes, completed by the SLPs, we retrospectovely reviewed. All TT were positioned correctly following the completionon of the procedure and were verified by passing a suction catheter to ensure no distal TT obstruction or by observing the subglottal anatomy through fiberoptic

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