How to manage tracheostomy tubes

Most nurses are not thrilled to learn they will be caring for a patient with a tracheostomy tube on their shift. They are difficult, intensive, and continually require cleaning. Patients with tracheostomy tubes require extra time and nursing care involving humidification, aseptic wound care, suctioning, and removal of secretions.

Most practices do not deal with these patients on a regular basis. However, practices should create a documented set of procedures for veterinary nurses to follow when a patient requires tracheotomy tube care. Outcome of these patients is largely dependent on the care provided by veterinary nurses (Figure 1).

Patients with severe upper respiratory obstruction are potential candidates for tracheostomy tube placement. Causes for such obstruction may include inflammation, laryngeal paralysis, brachycephalic syndrome, or other causes that prevent ventilation and/or endotracheal tube placement.

A tracheostomy is a surgical procedure that involves creating an incision through the neck into the trachea. This allows the patient to breathe through a tube and also allows for easy access so that veterinary nurses can provide care and maintain the tube. Brachycephalic breeds, such as English Bulldogs or Boston Terriers, may require tracheostomy tube placement more than other breed types owing to the development of brachycephalic airway obstructive syndrome.