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About Linda L. Morris, Ph.D., APN, CCNS, FCCM

Tracheostomy specialist, Legal consultant and Co-editor/author of Tracheostomies: The Complete Guide, (Morris & Afifi, 2nd Ed. 2021, Chicago: Benchmark Health Publishing)

Case Study: A 68-year old male presented to the Emergency Department with a progressively enlarging right neck mass, new dyspnea, dysphagia, and hoarse voice.

Tracheostomy is a commonly performed procedure indicated for facilitation of prolonged ventilatory support, relief of upper airway obstruction and management of secretions. Postoperative complications may arise and are associated with significant morbidity and mortality1. It has been shown that health care professionals lack knowledge in the management of displaced tracheostomy tubes.2 A 68-year old

Welcome to Trach Resource

Originally published on December 1, 2009Welcome to Trach Resource. This blog is intended to be a networking and educational resource for the professional who works with tracheostomy patients. By sharing our experiences, we can better understand the needs of our patients and care for them safely. We welcome comments and questions from our book, Tracheostomies:

First Trach Change

Originally published on November 30, 2011 There is very little research regarding when it is safe to do the first tracheostomy tube change. Commonly, the first tube change is done between post-op day 7-14. A study was just published in Critical Care Medicine and showed that it is safe to do the first tracheostomy

Complications During Tube Replacement

Originally published on June 23, 2010 C.L. asks, "What are the chances of esophageal or tracheal rupture, or subcutaneous emphysema with reinsertion of a dislodged tracheostomy tube?" Answer: I have never encountered esophageal nor tracheal rupture during reinsertion of a dislodged tube. Nor am I aware of any reports in the literature. Theoretically, it could

Positioning for Trach Reinsertion

Originally published on July 30, 2010 C.L. asks, "If inadvertent decannulation occurs, what is the best patient positioning for reinsertion?" Answer: Supine positioning with neck hyperextension is ideal for reinsertion. However, this may not be appropriate for all patients. The key is visualization of the stoma and adequate lighting. I have reinserted trachs in all

Frequency of Tube Changes

Originally published on November 23, 2010 J.C. asks, "How often should a tracheostomy tube be changed? Answer: Tracheostomy tubes should be routinely changed on a regular basis to prevent infection and other complications; and in the case of children, to keep up with their growth and development. Most manufacturers recommend changing their tubes every 30-60

Bloody Secretions

Originally published on October 5, 2010 B.L. asks, "What should I do if the secretions become bloody? Am I suctioning too much?" Answer: Secretions can become bloody because of tracheal irritation. And yes, this can be caused by frequent tracheal suctioning or strong coughing. However, the presence of bloody secretions should not cause you to

Emergency Equipment

Originally published on October 12, 2010 Nurse C.D. asks, "What type of emergency equipment should I have at the bedside?" Answer: One must always be prepared for an emergency, and the key is to have essential items always available. These items include: extra tracheostomy tubes of the same size and type, as well as one

Your Most Valuable Tool

Originally published on October 31, 2010 B.W. asks, "What does it mean if I start to have trouble passing the suction catheter?" Answer: Meeting resistance upon passage of a suction catheter usually means one of two things: either the inner lining of the tracheostomy tube is becoming coated with secretions, or the tracheostomy tube has

Water or Saline?

Originally published on May 6, 2010 A respiratory therapy student asks, "What am I supposed to use to inflate the cuff of a Bivona TTS trach? I've heard they should be inflated with water, but I've also heard saline. Which is it...and why?" Answer: The Bivona TTS and the Arcadia CTS tubes are both made

NOTICE

The principals of TrachResource.com have made every effort to use sources believed to be reliable to provide information that is accurate and compatible with the standards generally accepted at this time. Because medical science is continually advancing, our knowledge base continues to expand. Therefore, as new information becomes available, changes in procedures become necessary. We recommend that the visitor always consult current research and specific institutional policies before performing any clinical procedure. The principals shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or reliance on, the information contained within this website.
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