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Thread: Trach secreations

  1. #1
    Senior Member
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    Jul 2001
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    Marion Iowa USA
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    458

    Trach secreations

    I got a trach 3 months ago and Currently take Rubinal for stopping secreations. What are the other Medications for stopping secreations?

  2. #2
    Trach secretions are normal, and will increase or decrease in amount in relationship to several factors. Tracheal secretions are mostly mucous, and help to protect your tracheal tissues from infection and injury. Having a trach will usually increase the amount of secretions you produce simply because of the presence of the trach tube inside your body, and increased presence of bacteria in the pulmonary tree.

    Infection will increase the consistency, amount, and color of secretions. Normal secretions should be thin and clear to slightly white. A major risk factor for tracheal secretion infection is aspiration of food, fluids, and even saliva from the oralpharynx. Do you eat orally or are only on tube feedings? Are you receiving special oral care on a regular basis (ideally every 4 hours) with CHG antiseptic to keep down the bacterial content of your saliva? Can you easily swallow your saliva? Have you had a swallow study if you are taking anything orally?

    Is everyone caring for your trach using sterile procedure for suctioning? Is anyone using tracheal irrigation with saline when suctioning you?

    Excessive suctioning can make you produce excessive secretions. Are you getting suctioned a lot?

    Do you get mucous plugs? How thick is your normal mucous? How are you being hydrated (oral water, water in tube feedings, etc.)? Are you getting humidification of your trach when it is not corked/plug in place (such as if being left open or on a ventilator)?

    Robinul is rarely appropriate for decreasing tracheal secretions. It can reduce saliva production and drooling if you have this problem. It is used in anesthesia sometimes, and in hospice care sometimes. Anticholinergic drugs such as Robinul (glycopyrrolate), Atropine , and Scopolamine have been used to reduce production of saliva, but also can cause other side effects such as urinary retention, flushing, increased body temperature, lack of sweating, slowed digestion, and an increase in autonomic symptoms (including AD) for some. Their use should be as a last resort for management of such problems with excessive saliva. I could not find a good resource suggesting their use for pulmonary secretions; in fact they can make the pulmonary secretions so thick that problems with mucous plugs and difficult suctioning can occur.

    (KLD)

  3. #3
    I had a trach for about 3 months when I was injured and remember the secretion thing, and I don't recall any medication given for that. My Dr. said the same thing as KLD, as long as the trach is there there will be secretions.

  4. #4
    Senior Member
    Join Date
    Jul 2001
    Location
    Marion Iowa USA
    Posts
    458
    I get suctioned once or twice daily
    Sterile procedure is being used
    watch in tube feeding only. Nothing orally. Always plugged. Rarely get mucous plug. Mostly thin mucous
    I get 30ml water hourly. Is that enough?

    Quote Originally Posted by SCI-Nurse View Post
    Trach secretions are normal, and will increase or decrease in amount in relationship to several factors. Tracheal secretions are mostly mucous, and help to protect your tracheal tissues from infection and injury. Having a trach will usually increase the amount of secretions you produce simply because of the presence of the trach tube inside your body, and increased presence of bacteria in the pulmonary tree.

    Infection will increase the consistency, amount, and color of secretions. Normal secretions should be thin and clear to slightly white. A major risk factor for tracheal secretion infection is aspiration of food, fluids, and even saliva from the oralpharynx. Do you eat orally or are only on tube feedings? Are you receiving special oral care on a regular basis (ideally every 4 hours) with CHG antiseptic to keep down the bacterial content of your saliva? Can you easily swallow your saliva? Have you had a swallow study if you are taking anything orally?

    Is everyone caring for your trach using sterile procedure for suctioning? Is anyone using tracheal irrigation with saline when suctioning you?

    Excessive suctioning can make you produce excessive secretions. Are you getting suctioned a lot?

    Do you get mucous plugs? How thick is your normal mucous? How are you being hydrated (oral water, water in tube feedings, etc.)? Are you getting humidification of your trach when it is not corked/plug in place (such as if being left open or on a ventilator)?

    Robinul is rarely appropriate for decreasing tracheal secretions. It can reduce saliva production and drooling if you have this problem. It is used in anesthesia sometimes, and in hospice care sometimes. Anticholinergic drugs such as Robinul (glycopyrrolate), Atropine , and Scopolamine have been used to reduce production of saliva, but also can cause other side effects such as urinary retention, flushing, increased body temperature, lack of sweating, slowed digestion, and an increase in autonomic symptoms (including AD) for some. Their use should be as a last resort for management of such problems with excessive saliva. I could not find a good resource suggesting their use for pulmonary secretions; in fact they can make the pulmonary secretions so thick that problems with mucous plugs and difficult suctioning can occur.

    (KLD)

  5. #5
    Why was the trach placed?

    Do you swallow your own saliva or must you be orally suctioned?

    Are you getting oral care with CHG antiseptic, and if so, how often?

    What makes you or your providers think you have "excessive" secretions? Who recommended or ordered the Robinul?


    (KLD)

  6. #6
    Do you use a humidifier? If so do you get excessive rain out/condensation that forms into water drops in the pipe? If so make sure that the tube has the water drained before any movement/rolling. Aspirating warm water isn't something you want to do.

    It get secretions suctioned out, was told that my lack of movement (c3 complete) affected things as AB you move and secretions don't stick as easily. Make sure that you know your usual vent flows, f they drop it can be an indication that you need a suction (or inner tube blocked with secretions). 4 years on a vent for me, no chest infections but we are meticulous on correct suctioning technique and not aspirating water.

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