RT Clinic: Comparing different tracheostomies with the Shiley Flexible trach
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- čas přidán 6. 07. 2020
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The Shiley Flex delivers the best of both worlds with a fixed resuscitative adapter and the option to use disposable inner cannulas. Here's a comparison with the standard shiley and bivona trachs.
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Thank you for all of your videos. I’m an RN and my weakest area is respiratory. I’ve been floating a lot in the ICU and your videos have really helped me.
Great information. I'm glad that they are making improvements in trachs. I have a question and hopefully you can settle a debate I have with my respiratory director. When should oxygen bubblers be changed? What is your institutions policy? Me, I think we should change them when they get low on the sterile water. She, thinks they should be changed every 72 hours like with do with our nebs. She believes they are a potential source of bacterial growth. I cannot find any study or literature on this. Thanks!
Thomas,
Thanks for the question. My facility does not routinely change the bubblers. One manufacturer (Hudson RCI) doesnt have specific recommendations on changing it out. It was probably a recommendation by your infection control dept. Our IC has swabbed nebulizers before looking for bacteria. You might want to recommend IC swabbing the bubblers or flowmeters for bacteria.
I wonder what the advantage is with the taper guard cuff. It seems like the high volume, low pressure cuff would provide more surface area to contact the trachea, requiring less pressure to achieve an appropriate seal.
Per the reps... the large amount of surface area contact may allow for wrinkles or folds in the cuff causing microaspiration. I've heard their talking points a few times, it make since, but.. I can't prove it happens.
Could the first number represent the size of the inner diameter when the inner cannula is in place?
That's a good thought. The first number is just an arbitrary sizing system where 4 is less than 5 and 6 is greater than 5.
Why are some trachs referred to as Coviden and some as Shirley??
Covidien is a manufacturer's name. The problem with that is Covidien can be brought by another company...and they have already, Medtronic.
Shiley is a type of trach and much more of a universal term.
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Oropharyngeal airway?