Total Pageviews

Sunday, May 30, 2010

What is Downsizing?

P.T. asks, "What is the purpose of downsizing?"

Answer: The purpose of downsizing is to allow the patient to do more breathing around the tube, rather than through the tube. When the initial problem that initiated placement of the trach is resolved, downsizing may begin. For example, when the tube was placed because of prolonged mechanical ventilation, downsizing can begin as soon as the patient has been weaned from the ventilator.

Downsizing should begin with cuff deflation, which allows admixture of room air, lowering overall FiO2. So downsizing should not begin until the patient is hemodynamically stable and can tolerate cuff deflation.

When the patient is able to tolerate cuff deflation, the tube can be changed to one with a smaller outer diameter. Capping can begin at that time (and never with a standard cuffed tube).

The end result of downsizing is usually with the overall goal of decannulation; however, the tube may need to be downsized in order to allow enough air around the tube to reach the vocal cords for phonation. See the Downsizing Algorithm in Chapter 11 for a step-wise procedure on downsizing.

2 comments:

  1. Spot on with this write-up, I really think this website wants much more consideration. I’ll most likely be once more to learn way more, thanks for that info. best online casino

    ReplyDelete
  2. My husband was diagnosed with early onset Parkinson's disease at 57.his symptoms were shuffling of feet,slurred speech, low volume speech, degradation of hand writing, horrible driving skills, right arm held at 45 degree angle, things were tough for me, but now he finally free from the disease with the help of total cure from ULTIMATE LIFE CLINIC, he now walks properly and all symptoms has reversed, he had trouble with balance especially at night, getting into the shower and exiting it is difficult,getting into bed is also another thing he finds impossible.we had to find a better solution for his condition which has really helped him a lot,the biggest helped we had was ultimate life clinic they walked us through the proper steps,am highly recommended this www.ultimatelifeclinic.com to anyone who needs help.

    ReplyDelete