Mar 11, 2009

First Ever Emergency Trach Change

When you have a child with a tracheostomy you have to always be prepared for an emergency. Everywhere Ainsley goes we always have to have a suction machine to clear the airway of secretions, saline to help thin the secretions if needed, a spare trach in case something happens and another spare trach in a smaller size in case the regular size won't go in. In addition we always have a resuscitator bag and tanks of oxygen in the car. Of course we have all these same supplies at home.

In the two and half years of living with a trach we've had 1 911 call due to RSV and two accidental decannulations. Fortunately in both those situations the trach, while there was no longer a patent airway because the trach cannula was not in the trachea the cannula was still ever so slightly inside the neck, allowing it to be reinserted fairly easily. Never in this whole time have we used our spare trach. I was surprised that today was the day.

We headed with our nurse to Children's Hospital for the swallow study. Afterward we have a few hours before our next appointment so we head to the toy store to buy a jumbo 14' jump rope for Evie's school auction basket. As we are leaving I see in the rear view mirror that Ainsley is asleep. Her color is good but she is gasping for breath every few seconds. She sounds a little dry but not particularly junky. I get out of the car and suction her because I don't like the sound she's making. The suction catheter passes through the tube but it feels ever so slightly tighter. I use an entire saline bullet to help thin the secretions but there is still a slight whistle sound. Since the catheter passes we head back to the hospital for her orthopedic appointments.

The strange sound is still there and I still can't get it to go away no matter what I do. I realize that I'm going to have to change the trach. I get it out of the bag and lube it. I pull the trach and the nurse puts the new one in. I push the obturator (device for inserting a tube) through the cannula and out pops this sticky secretion that had been stuck inside the cannula. It has a very unusual consistency like half dried Elmer's glue. I washed the old trach in the bathroom just in case I needed it later (even a non-sterile trach is better than no trach in an emergency).

We proceeded to our appointments and all was fine. Later that night when I suctioned her I got another glue like plug stuck inside the suction catheter. After thinking it over I realized the next day it must have been some of that barium she'd aspirated was mixed in with her secretions causing it to form like glue.

Thankfully things were better the next day and I'm hoping it was a fluke. I'd come to feel pretty sure I wasn't ever really going to need those spare trachs I'd been carrying around so this was a good reminder why.

See the sticky stuff on my finger?

1 comment:

  1. Oh my - I'm glad everything was okay and she didn't rapidy decompensate. Darn barium!