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What is an Inner Cannula for Tracheostomy and its Purpose? Quick Tip for Families in ICU!

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

Currently, we are working with a client who has their loved one in intensive care. He’s 72, he’s had a stroke late last year in 2023, and he’s now apparently having trouble weaning off the ventilator with the tracheostomy. Now apparently, he was breathing spontaneously for a couple of days and then he ended up with a sputum plug. Sputum plug with a tracheostomy basically means that sputum has been built up in the tracheostomy and the tracheostomy blocked. That led to some form of respiratory arrest or respiratory depression probably, had declined probably, or the patient probably had a bit of a shock, and it ended up going back on the ventilator.

Now, first off, let me show you what an inner cannula is. A lot of you wouldn’t know what an inner cannula is. I’ll quickly show you a tracheostomy here. I hope you can see this. This is what a tracheostomy looks like. Then an inner cannula is this device here and that goes into the tracheostomy I hope you can see that here and, it can go in and out.

Now, here’s the purpose of it, especially when there is mucus buildup, you can change the inner cannula quite frequently. You can change it every 2 hours. You can change it every 4 hours. The minimum change frequency is usually once every 8 hours.

Now, if you’re not doing that and you’re not suctioning regularly or you’re not giving humidified air or humidified oxygen or you’re not giving regular saline nebulizers, the patient is at risk of having a tracheostomy blockage leading to a potential respiratory arrest or even worse.

So, and that’s why I keep saying over and over again when it comes to tracheostomy and ventilation, patients need to be in ICU. They can’t be anywhere else for exactly those reasons because these things can happen. It shouldn’t happen, but they may happen. With all good intent and purposes, with all good intent, it still may happen. They may have done all the right things and it nevertheless blocked.

However, the tracheostomy with an inner cannula in particular, it’s almost like a safety mechanism because if you take out this inner cannula and you can actually have a look if it’s soiled, if mucus is building up, like I said, it’s like a safety valve.

Also, if your loved one has a tracheostomy in the ICU, you should find out if he has an inner cannula or not, or for anyone having a tracheostomy, whether there’s an inner cannula or not. Here is the rule of thumb when patients have an inner cannula and when they don’t, the rule of thumb is that for patients where you expect that they have a high mucus build up, lots of secretions, you use an inner cannula.

Patients where sputum production is expected to be lower, you often don’t need an inner cannula but that can also be hard to predict because in some instances. You just don’t know what might happen down the line. But it is important for you to understand if you have a loved one in intensive care, what is an inner cannula? What’s the purpose of it? What else should you be looking for?

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.

So, with all of that said, the best cure is always prevention which means if you have a loved one in intensive care, you do need help. Just like this family who came to us when it was nearly too late. They realized they’re out of their depth and that’s why they reached out to us and engaged my service here for consulting and advocacy. So, they know what lies ahead so that they’re not being taken for a ride. I’m not suggesting that ICUs are taking people for a ride but that’s how some families feel regardless.

Because families in intensive care need help and because they have a ton of questions, that’s why we created a membership for families of critically ill patients in intensive care at intensivecarehotline.com. You can get access to our membership at intensivecarehotline.com by clicking on the membership link or by going 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 access to 21 e-books and 21 videos that are specifically written and recorded for families in intensive care so that you can manage pretty much any situation in intensive care so that you know what’s going on behind the scenes and how you act and interact with intensive care teams so that you can get the outcomes that you want. But more importantly, that you make informed decisions, have peace of mind, control, power, and influence.

I also offer one-on-one consulting and advocacy over the phone, via Skype, Zoom, email, WhatsApp, whichever medium works best for you. I talk to you and your families directly, but I also talk to doctors and nurses directly. I participate in any family meetings you might have with intensive care teams, and I make sure you make informed decisions, you have peace of mind, control, power, and influence, and your critically ill loved one gets the best care and treatment.

I have worked in critical care for nearly 25 years in three different countries where I also worked as a nurse unit manager for over 5 years. I have been consulting and advocating for families in intensive care all around the world since 2013.

I can say without a shadow of a doubt that we have saved lives with our consulting and advocacy. You can look up our testimonial section or you can listen to some testimonial videos or podcasts in our podcast section, verifying everything that I’m saying.

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

All of that, you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or 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, comment below what you want to see next, what questions and insights you have.

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.