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If your loved one was not able to breathe normally as a result of a traumatic injury or accident, stroke, or other severe illness, then he or she may have undergone a tracheostomy, or trach, procedure while in the hospital. Whether your loved one's tracheostomy is permanent or temporary, it will need to be cared for on a regular basis. Once the individual has been discharged from the hospital with the tracheostomy tube still in place, he or she may need the following hospital-at-home care interventions by trained medical personnel.
Tracheostomy patients need routine care of the ostomy site. The inner cannula of the ostomy will be meticulously cleaned so that your loved one's airway does not get clogged with thick mucus. Once the inner cannula has been removed, it will be placed in a cleansing solution such as peroxide. The nurse or respiratory therapist will then use a small brush to scrub away any hardened material that has accumulated on the surface of the cannula.
If the trach patient is unable to expel mucus secretions on his or her own, then the healthcare provider will suction the ostomy, which will extract the mucus through a suction tube. During routine "trach care," the staff member will also examine the skin surrounding the ostomy for redness, inflammation, skin breakdown, bleeding, or unusual drainage. If any of these signs are found, both you and your loved one's physician will be notified, who will recommend a treatment plan.
People who have tracheostomies are at risk of developing respiratory infections. The hospital-at-home staff members will monitor the patient for signs and symptoms of a respiratory infection so that prompt interventions can be implemented.
These signs and symptoms may include an increase in tracheal secretions, coughing, choking, and fever. If the infection is thought to be bacterial in nature, the physician may prescribe an intravenous antibiotic. If a virus is suspected, antibiotics will not be prescribed, as they are ineffective in treating viral infections of the respiratory tract.
The physician may also prescribe intravenous fluids to help prevent dehydration caused by a fever. Other signs of infection that the staff will monitor for may include lethargy, loss of appetite, headache, body pain, and even decreased urinary output.
If your loved one has a tracheostomy, call a hospital-at-home representative to learn how the staff can help. When tracheostomies are well-maintained by healthcare professionals, patients are less likely to develop infections, difficulty breathing, and even anxiety caused by ineffective breathing patterns.