The process whereby a tracheostomy tube is removed once patient no longer needs it. This study aimed to analyze the literature and verify the tracheostomy decannulation protocols used in international studies, observing the professionals involved, and describing the steps of this process. Tracheostomy decannulation heidi h oconnor md and alexander c white md introduction process of weaning and routine decannulation managing accidental decannulation post decannulation monitoring decannulation failure and alternatives to decannulation summary tracheostomy tubes are placed for a variety of reasons, including failure to wean from. It is a multifactorial process and the protocols may vary from one setting to another. Pdf tracheostomy decannulation methods and procedures in. Although capping trials provide a good sense of how you will tolerate breathing without the tracheostomy tube, it is important to remember that breathing will be easier following decannulation. Protocol guided decannulation evidencebased guidelines have confirmed the benefit of weaning protocols. Clinical criteria for tracheostomy decannulation in.
In the literature, there are different decannulation protocols designed mostly for acute intensive care where tracheostomy tubes are expected to be removed after a short time period. A patient is considered a candidate for decannulation once the following conditions are met. Emergency response to accidental tracheostomy decannulation staff this document applies to. Medical staff, nurses, speech pathologists, physiotherapists on all campuses does not apply to icu staff or to staff working in the community.
Therapist driven weaning protocols, such as those involving spontaneous breathing trials or decreasing levels of pressure support, have been. Pdf decannulation is an essential step towards liberating tracheostomized. In a randomized trial of critically ill patients, cuff deflation has been shown to reduce weaning time for individuals with tracheostomy who are spontaneously breathing hernandez, g, 20. Tracheal decannulation protocol in patients affected by. Success of a respiratory therapistdriven tracheostomy.
Most decannulation protocols involve increasing periods of time for cuff deflation. Tracheostomy, decannulation, respiratory obstruction, prolonged. Should be done as soon as medically safe and immediately place occlusive dressing. Follow institutional protocols for transport of covid19pui patients. If 247 capping is well tolerated, this is a good indication the tracheostomy tube is no longer needed and decannulation can be planned. Artificial airway inserted into the trachea during tracheotomy. Patient is alert and oriented and responsive to commands. Not all patients are suitable for a weaning protocol, and. Tracheostomy decannulation austin publishing group. Over many years, the interference of tracheostomy on swal lowing has been studied. When the initial indication for a tracheostomy no longer exists. Michigan medicine tracheostomy guidelines in covid19 era.