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Quick Tip for Families in Intensive Care: How Can the Copious Tracheostomy Secretions for My Husband in ICU be Reduced?

 

Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

Today’s tip is about again, a question from one of our members. We have a membership for families of critically ill patients in intensive care and we answer all questions, intensive care related there. And if you want to become part of our membership for families of critically ill patients, I encourage you to go to intensivecarehotline.com. Click on the membership button or go to intensivecaresupport.org.

Also, if you like my videos, subscribe to my YouTube channel, click the like button, click the notification bell, share the video with your friends and families and comment below what you want to see next or what questions and insights you have from this video.

Let’s dive right into it.

So, we’ve got a question from one of our members who has had her husband in ICU for many weeks now and he’s got a tracheostomy and she obviously has many, many questions because families in intensive care simply don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care. And this is exactly what our member is dealing with here. Anyway, let’s get to her question.

Hi, Patrik and Team,

My husband’s oxygen saturation is 100%. The secretions are not thick, but they are a lot, and he is suctioned very often and I’m learning to suction as well. I’m wondering whether there’s anything that can be done so that his secretions are becoming less.

So, let’s dive into the answer.

Thank you so much for your email and for the update. It’s good to know that your husband is having good oxygen saturation of 100%. However, his thick and excessive secretions need to be addressed and managed. Could you describe the color of these secretions? Also, has he had any recent fevers?

The need to further assess him, especially if he’s having a lot of secretions as this might possibly be the onset of a lung infection. They can further investigate and send a sample of his sputum for a culture. Because if you do a sputum culture, you can actually find out if you know your husband has a has an infection. Otherwise, these secretions that are plentiful can also be managed by potentially ensuring a balanced fluid.

So, if he has a lot of secretions that are not thick, he might be simply a little bit overhydrated. Maybe it could just simply be reducing fluid intake. If they are thick on the other end, you go the other way, maybe you give him a little bit more fluids and more hydration. It’s a fine balance.

Humidification also helps to keep the secretions thin and prevent mucus plugs. And I would not recommend reducing humidification because then you’re going in the other direction, and you might end up with these sputum plugs that could complicate things and could lead to a medical emergency or even worse.

I would also still continue with the nebulizer, a saline nebulizer or with the Ventolin nebulizer as it helps moisten and loosen secretions, making it easier for him to cough them out.

So, thin secretions are not necessarily a bad thing. Not at all. As long as they’re coming up, it’s very important that they keep coming up and that they’re easy to get out.

Obviously, chest physiotherapy is another option that can be done for your husband to help with mobilizing the secretions and help with expelling the sputum. Physical mobilization also needs to happen to help strengthen his lung muscles and promote effective coughing.

Speaking of suction, it’s great that you are learning this technique. However, it is important that you have received proper training in tracheostomy suctioning. Using the right approach is vital to prevent adverse events and always ensure to use sterile equipment and sterile technique to prevent introducing bacteria and infection and follow the guidance of a skilled nurse when performing suctioning. Tracheostomy care is also important, and this should be done by the skilled ICU nurses as well.

I have made plenty of articles about that. I would not necessarily recommend you doing the suctioning. I would only do it under supervision if I was you because a lot of things can go wrong and a medical emergency, a dislocation of the tracheostomy, an airway blockage could be triggered if you’re not following the right technique.

For example, when patients are at home with a tracheostomy, patients have died because they haven’t had the 24-hour critical care nurse that they inevitably need with a tracheostomy. So be careful there.

If the issues with thick or thin and excessive secretions persist, we may suggest that your husband be referred to his pulmonary doctor ASAP. Inform them about your husband’s thick or excessive secretions to address the issue and prevent potential complication.

Your husband’s vital signs need to be regularly monitored, especially his oxygen saturation levels and overall condition. Be vigilant for any signs of distress or changes in breathing and refer to the doctors or nurses promptly.

We continue to pray for your husband’s healing and recovery.

I’ve also put some links to articles and videos that I’ve done around this topic. And you can follow them up as well.

One link that I put there is, “Can My Husband with a Tracheostomy and Lots of Secretion Use a Passy-Muir Speaking Valve?” . There is a section about secretion management. I’ll put a link there and also tracheal suctioning.

Now, that’s my quick tip for today.

Now, if you want to become part of our membership for families of critically ill patients in intensive care, where we answer your questions 24 hours a day in a membership area and via email and where you have access to me and my team 24 hours a day in a membership area and via email, go to intensivecarehotline.com, click on the membership button or go to intensivecaresupport.org and you can get access there.

I also offer one-on-one consulting and advocacy for families in intensive care over the phone, via Skype, via email, via phone, Zoom, WhatsApp, whichever medium works best for you. And I talk to doctors and nurses directly with you. I ask all the questions you haven’t considered asking, but you must ask because otherwise you can’t make informed decisions, have peace of mind, control, power and influence and it’s critical for you that you have a second opinion in real time.

I also represent you in family meetings with the intensive care team, so that again, you are in a position so that you can make informed decisions, get peace of mind, control, power, and influence. It’s critical that you have that second opinion in real time.

And we’re also reviewing medical records in real time where again, we give you a second opinion in real time. We also review medical records after intensive care if you have unanswered questions, if you need closure or if you’re simply suspecting medical negligence.

Now, if you like my video, subscribe to my YouTube channel  for regular updates for families in intensive care, click the like button, click the notification bell, share the video with your friends and families and comment below what you want to see next or what questions and insights you have from this video.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com, and I will talk to you in a few days.

Take care for now.