Tracheostomy care

Don't know if anyone here will know, but thought I'd post anyway...

The saga w/my mother continues.  She was back at the emergency room 2 days ago due to fever and horrible coughing.  Turns out she's got infection in her lungs and at the trache site.  They're treating her, although she still feels like cr*p.  She's on an antifungal (they think it's yeast at the trache site) and is taking albuterol (sp?).  The albuterol is a bronchiodilater (sp?), if I understand correctly.  Her biggest concern (and mine) is that her secretions are incredibly thick and sticky and she seems in real danger of another total airway obstruction.  She's afraid to sleep at night because she thinks she could stop breathing and simply not wake up.  My question is this...does anyone know why she shouldn't be given an expectorant as well?  I know it won't reduce the quantity of the secretions, but it should thin them out enough to where she could cough them up more easily.  Should I be calling the home health nurse about this?

Should I be calling the home health nurse about this?

Yes and what about her regular doctor?

I hope your mother improves soon.

I work with some families who have to provide overnight suctioning care to reduce the risk of obstruction. Is this anyway a possibility?

I work with some families who have to provide overnight suctioning care to reduce the risk of obstruction. Is this anyway a possibility?

Well, she went back to the doctor again today.  They now think it's a staph infection.  She does have suction equipment and suctions herself 3-4 times per night.  She's afraid to sleep, so she's not getting any rest to speak of.  She did ask about an expectorant...the doctor said sometimes it helps and sometimes it doesn't, but gave her some samples.  I'm hoping it helps.  At this point, they're going to try and take the trache out in a couple of weeks...assuming the swelling goes down between now and then. 

Your poor mom!  What a nightmare. 

I work in ICU and work quite a bit with trachs.  If she doesn't get any relief with the expectorant, have er ask about a nebulizer for saline nebs (makes it into a fine cool mist) which we use a lot to help keep secretions loose and easier to bring up.  It can also be used for her albuterol.

I understand her being afraid to sleep at night, but try to reassure her that if she starts to plug off she will indeed wake up. 

I hope she gets some relief.

A quick update...they finally prescribed her an expectorant and it has made a world of difference!!!  She's able to sleep at night again w/out having to get up several times a night to suction her trache, and she's able to cough up all the gunk that's been accumulating in her lungs.  She's still being treated for both a staph infection AND a yeast infection at the trache site, but is slowly getting better.  She's hoping to get the trache out in about 10 days.  She had a long chat w/the doctor and said that her quality of life is MUCH poorer now than when she was living w/sleep apnea, and that the trache seems to be causing additional (serious) health problems for her.  The doctor seemed quite sympathetic.  They're planning on taking the unusual step of removing the trache in hospital and keeping her in overnight for observation.  Fingers crossed...there appears to be a light at the end of the tunnel!

Really glad to hear this!!