The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

Weaning and Decannulation: Swallowing Studies and How to Decannulate

Mike Harrell, BS, RRT, Sunday, December 7, 1997.

The development of a successful process for the assessment and care of patients with artificial airways included in the consideration of the timing of tracheostomy, the selection of tracheostomy tube type and the ongoing care of the patient regarding the artificial airway. A branching logic assessment tool was developed to assist respiratory care practitioners, nurses, speech and language pathologists and physicians in the development of individualized care plans consistent with standards of care accepted by the medical staff of the facility. Communication among the responsible professionals assists in the decision making process for the timing of performing a tracheostomy. Guidelines were established to assist in the decision making process.

Several tracheostomy tube types and manufacturers were evaluated, and a set of standard tube types, manufacturers and sizes was established.

The assessment tool developed along with the assessment documentation provides a mechanism for individualized care plan development with guidelines for issues such as the use of swallow studies for evaluating the functional level of the airway, the use of a Passy-Muir speaking valve and the involvement of an ENT physician consult when necessary. The selection of weaning procedures and decannulation are also guided by this process.

A process for providing specific education for the disciplines involved was developed and is a continuing part of the Artificial Airway Assessment Care Plan.

AARC 50th Anniversary, December 6 - 9, 1997, New Orleans, Louisiana.

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