W.C. asks, "I've noticed a small amount of bleeding from my trach recently. Should I be worried?"
Answer: The two most frequent causes of tracheal bleeding are due to frequent suctioning and lack of humidity. Regarding frequent suctioning, one should not decrease the frequency of suctioning just because of the appearance of some blood. Rather, this should be a cue to switch to softer suction catheters. I usually recommend red rubber catheters, which are not suction catheters, but are actually they are urinary catheters, technically called "coude" catheters. These are especially helpful because the tip is closed, rather than open, so there is less trauma to the tissue with the use of these catheters. Because the tip is closed, they may not be quite as effective as the standard suction catheters, but complete healing of tracheal tissue has been observed in as little as 24 hours after the switch, so this is an option. Please note: Red rubber catheters cannot be used in the patient with a latex allergy.
The other frequent cause of tracheal bleeding is lack of proper humidity. This is especially true in the fall and winter in colder climates....or other places that have low humidity (like hospitals!). This dried blood can collect within the tracheostomy tube and begin to occlude the airway. In fact, one patient had no trouble at home, but came to the hospital and required almost daily trach changes because of the accumulation of dried blood within his tracheostomy. The problem resolved as soon as humidity was added to his ventilator circuit.
Now that fall and winter is approaching, you may need some extra help with humidity. This can include room humidifiers, soaking a gauze in water or saline and placing lightly over your trach, using an HME (heat moisture exhanger), spritzing some atomized saline (Ocean nasal spray) into the trach and mucous membranes, increasing water intake, and more frequent changes.
If there is a large amount of bleeding, contact your health care provider for further evaluation.
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ReplyDeleteHello! My mother has AlS and she has been hospitalized for more than 3 years and she never suffered from tracheal bleeding.2 months (March 2012) she started bleeding(not very large amounts but frequent bleeding) from inside the trachea,this happens when she gets suction via trachea.So the RT's lavaged and it helped because she had less bleeding but it didn't completly solved the problem.On April 15 the trach changed was due so they changed the tracheostomy and I noticed that the trach changed helped because she had less frequent bleeding but near the end of the month period for trach change she started bleeding the same as in March and on the 6 of this month (May 2012) my mother had bleeding coming from her throat,from the inside.I am positive is from the inside because theres no bleeding around the mouth or lips and because my mom told me its coming from her throat also that she was feeling burning and pain.A lot of bleeding was coming at the time of suctioning the mouth.My mother asked for suctioning often.The nurses notified the doctor and the doctor decided to hold aspirin for some days.
ReplyDeleteI will like to know how bleeding coming from the throat can relate to trach bleeding?
Also how can bleeding be stoped?
THANK YOU!
My sister is in coma for last one yaer .she got readmitted 2 months due to excessive tracheal secretions and her tracheostomy was changed recently .now for last few she is having fresh bleeding from tracheostomy tube when i do her suction .what would b the reason ?plus she is having strong cough for last few days .
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