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Thread: SCI Nurse - Advice on Trach

  1. #1

    SCI Nurse - Advice on Trach

    I'm sorry to have to post this but my friend has joined our little club by getting a C4 injury.
    As you can guess his family is overwhelmed. He was just moved to a rehab facility and then moved back to the hospital because of pnemonia. The pnemonia is under control and getting better but the doctors there are saying he should have surgery to have a trach put in.
    His wife is getting conflicting stories about the benefits and downsides of trachs. I never had a trach so I really can't provide any direct experience. The trach is suppose to reduce the chances of pnemonia but what are the downsides?

  2. #2
    Leaving someone fully intubated for too long can damage the windpipe as well as stops their ability to speak. Sounds as if he needs help breathing to allow his lungs to heal and clear up. I believe they don't like to use intubation longer than 5-7 daays before putting in a trach.
    Every day I wake up is a good one

  3. #3
    Thanks for the reply cheesecake. As far as I know he can breath fine on his own. The implication from his doctor is that he would be less likely to come down with another case of pneumonia with the tract and that if he does it will be easier to deal with. I'm meeting his daughter this afteernoon so I'll know a little more about his condition.

  4. #4
    Senior Member BeeBee's Avatar
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    Dec 2004
    Washington, D.C.
    A trach can allow him more mobility and provide him with the ability to talk (depending on the valve) and eat. It is more comfortable than a tube in the thoat.

  5. #5
    First of all, where was he in rehab? Were they an expert SCI rehab facility? Did they know how to clear his secretions with a vibratory vest, Cough-Assist Machine, and quad coughing? There are options other than just suctioning (which is easiest with a trach). Trachs also allow bacteria into the lungs, and suctioning actually can destroy the cilia that clean the lungs. This can result in more suctioning causing more secretions.

    If just suctioning is needed, and he can actually breath OK (what is his vital capacity), then an Olympic Trach Button (not a full trach) can be used to allow access for suctioning. This cause fewer complications, is cosmetically preferable, and can also be easier to use for talking. It can be used to maintain the stoma so that a regular trach can be inserted in an emergency if he needs to temporarily be on a ventilator (such as during a serious lung infection).


  6. #6
    Thanks for the replies. The doctors said that the tract is now medically necessary so his family had to have it done. He was just moved to the rehab hospital that I went to ad they are very good at handling SCI and dealing with respitory issues. There is a seperate wing dedicated to people who are vent dependent or have trachs.
    Even though I have a SCI I did not have to deal with many of the issues my friend and his family are about to deal with so I'm hoping i will able to get advice from others here.
    Thanks Litespeed4

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