Moving on from a Tracheostomy

[Pookyal]

Sorry - another question from me. As it was a slightly different topic, I thought I'd start a new thread.

My dad has had a trachy now for just over two weeks, following two weeks fully sedated on a ventilator due to pneumonia. He is much improved and breathing unaided for 36 hours so far. He is also taking sips of water through a straw and starting to stand up a bit. They were talking about removing his trachy over the weekend (tomorrow or Sunday) and I was just wondering what they then look for to transfer to a general ward? There is a nurses strike on Weds and Thurs so I am really worried that they will try and move him out of ICU before then but there will be noone looking after him. Or am I being totally unrealistic about timeframes and he's probably safe in ICU for a while longer? How long do they tend to monitor someone post trachy/ventilator on ICU before transfer? TIA

[Sepsur]

I stayed on ICU for a few weeks after my trachy was removed but this was because I kept picking up infections - it took me a long time to adjust to the wards & be strong enough to cope with them. I know the teams are keen to discharge asap - I’m sure this is down to pressures and the expense.

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[DB1996]

It he is stable and breathing unaided through his trachy this can be managed on a ward. Try not to worry I am sure they will take everything into account before moving him.

[FamilyHistorian in reply to DB1996]

first of all we are all different. I had my feed tube until the day I left hospital and had swallow issues.

My trachy was removed whilst I was still in icu and was told the wound should heal within a week or two. In my case it took longer than that. They put a dressing over the wound and this was changed quite regularly. The problem is that the wound, in my case, stays wet, slimy and smelly (not to put a fine point on it) and it did take longer than a few weeks to heal. Also when you speak you need to put pressure on the dressing so that it doesn’t leak. Because of my lack of coordination and strength I had difficulty pressing the right spot so they put an ecg nipple on the dressing. The best thing once the trachy is removed is that you can speak.

I stepped down to a cardiology ward and the care of the wound was fine. But the step down ward care might come as a surprise as it is not one to one.

Some people are shy about having a Tracky scar. It’s hardly noticeable but I wear mine as a badge of honour.

[Mich898]

Hi. Sorry to hear your dad has pneumonia. Please be careful about removing trach too early... When my dad had a stroke, he was breathing fine with it, till the doctors played with it at night and his oxygen levels went down and sadly he passed. Check his oxygen levels are ok on the monitor and don't let them do anything without your permission. . I think he's fine in ICU. least then he'll get round the clock care....thanks

[Pookyal]

Thanks all. The Trachy came out at the weekend and he seemed to really turn a corner. was at 94/95% O2 on a nasal cannula. However after a particularly intense physio session, his O2 dropped and they changed his O2 delivery. Turns out he had/has a hospital acquired infection. He is currently at 88/89% O2, but they still consider him 'wardable'. They are planning to move him to the respiratory ward. I know the monitoring is less there, but I am assuming they are able to deal with acute pneumonia and will continue to watch his O2 levels. Slightly worried because they are talking about moving him tomorrow in the midst of a nurses strike!