RE: [VENT-L] trach changes

[Larry Kohout]

Mark,   When I first had my trach put in, in July of 2001, I had a cuffed trach for 12 weeks.  It was changed every six weeks during that time.  The doctors then changed me over to a non-cuffed trach and taught my wife how to change it.  They suggested it should be changed roughly every six weeks.  We started out to follow their advice; however, I had a lot of difficulty with secretions building up around the distal end of the trach tube between the outer wall of the trachea and the trach tube.  We discovered that we could break this up very easily by changing the trach tube.  Ultimately, we devised a routine where we change the trach tube daily.  We simply soak the removed tube for 24 hours in hydrogen peroxide, then clean the tube with the trach brush, rinse it thoroughly with distilled water, shake it roughly dry, and put it back in the next day.   I recently had occasion to speak at an in-service training session for respiratory therapists.  One of the other speakers, after hearing about my routine said she thought I was wise in doing what I was doing as recent research has shown that various bacteria can in fact grow on the plastics used to make the trachs and inner cannulas.  Unfortunately, I did not ask for a citation, so I cannot reference it for you.  All that I can say is that I have been infection free over the three years that I've had the trach.  The only illness that I have experienced during that time was one head cold that my wife brought home from work with her.   Both my pulmonologist and my ENT surgeon who monitors the trach site keep saying "I don't know what you're doing, but keep it up, you have the best looking trach site I have ever seen."  I certainly cannot guarantee that this routine will work for everyone, but it is certainly working very well for me.   Peace, Larry (from the land of loons)   This outgoing message has been scanned by Trend Micro Internet Security for your protection.   My trach has been changed every 12 weeks since I got the trach in 2/03.  I started developing infections after the 6 week mark so I requested more frequent changes.  After much arm twisting my doc agreed to change it every 6 weeks.  But he warned me that changing the trach more often could bring infections. If this happens he said the changes would go back to every 12 weeks.  I just wanted input on this from you all.   Mark B.