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Quick Tip for Families in Intensive Care: Markers Your Loved One Needs Before Weaning Off a Tracheostomy

“Markers your loved one needs before weaning off a tracheostomy.”

My name is Patrik Hutzel from intensivecarehotline.com, where we help families of critically ill patients in intensive care and also after intensive care, so that you can make informed decisions, have peace of mind, real power, real control, and so that you can influence decision making fast, making sure your loved one always gets best care and treatment, even if you’re not a doctor or a nurse in intensive care.

So today’s question comes from Bridget who asks:

“Hi Patrik,

What are some of the markers my dad would need to make to wean him off the tracheostomy? He’s been off the ventilator for a few weeks now. He is maintaining good blood oxygen levels. He had 3 days in a row where he didn’t need much or to be suctioned. Today, he did need suctioning and he has a great cough. It seems like my dad is handling his secretions well, but I’m not sure if he’s had a swallow test at this point or results if he has had one.”

So, thank you, Bridget for writing in and let’s break this down for you.

Here are the key markers your loved one needs before weaning off a tracheostomy.

1. Stable breathing without a ventilator.

If your dad has been off the ventilator for days or for weeks, that’s a huge step in the right direction.

2. Stable oxygen and stable CO2 levels.

CO2 is also known as carbon dioxide. The blood gases need to show that oxygenation and ventilation are adequate.

3. Handling of secretions.

A strong cough and minimal suctioning needs are great signs if your loved one can clear secretions independently. That’s critical for decannulation.

4. Swallow function and airway protection.

This is where a swallow test comes in. A speech therapist usually checks if your loved one can swallow safely and avoid aspiration, and that also would require that the tracheostomy cuff is either down or that your loved one has a cuffless tracheostomy already.

5. Speaking valve or capping trials.

Tolerating a Passy-Muir speaking valve or having the tracheostomy capped shows they can breathe through the upper airway.

6. General strength and awareness

Being awake, alert, and strong enough to protect the airway, and call for help if needed is also vital. There you have it.

Now, Bridget, from what you’re describing, your dad has been off the ventilator, maintaining oxygen levels, needing less suctioning and having a great cough, it sounds like he’s making excellent progress.

Next important step is making sure he’s had a swallow test, and then asking the ICU or respiratory team, when will you trial my dad on capping for a speaking valve? That’s how you know if he’s ready for tracheostomy removal.

Just as a side note, it always helps if there’s good mobilization, good physical therapy. I hope that’s also happening. You haven’t mentioned it, but that’s also something you should be looking for, Bridget.

If you have a loved one in intensive care or after intensive care with a tracheostomy and you need help with weaning, decannulation, and navigating the ICU team, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or send me an email to [email protected].

Also, have a look at our membership for families in intensive care at intensivecaresupport.org where you can have access to me and my team, 24 hours a day, in a safe and private membership environment.

I have worked in critical care nursing for 25 years in three different countries where I worked as a nurse manager for over 5 years in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives with our consulting and advocacy because of our insights. You can verify that on our testimonial section at intensivecarehotline.com. You can verify it on our intensivecarehotline.com podcast section where we have done client interviews because our advice is absolutely life changing.

The biggest challenge for families in intensive care is simply that they 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.

That’s why we help you to improve your life instantly, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always. That’s why you can join a growing number of members and clients that we have helped over the years, saving their loved ones’ lives.

That’s why I do one on one consulting and advocacy over the phone, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. When I talk to families directly, I also talk to doctors and nurses directly, asking all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.

I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if in case you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

We also have a membership for families of critically ill patients in intensive care, and you can become a member if you go to intensivecarehotline.com, if you click on the membership link, or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. In the membership, you also have exclusive access to 21 eBooks and 21 videos that I have personally written and recorded. All of that will help you to improve your life instantly, make informed decisions, have peace of mind, control, power and influence, making sure your loved one gets best care and treatment always.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

If you like my videos, 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, what questions and insights you have from this video.

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Thank you so much for watching.

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

Take care for now.