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Weaning from tracheostomy

  • Supplemental oxygen requirement is less than 40%
  • The patient is haemodynamically stable
  • The patient is able to cough to clear chest secretions using vocal cords
  • The patient is able to maintain an upright sitting position in a bed or chair
  • The patient is able to stay awake and alert for 15 minutes while seated upright
  • The patient requires occasional suctioning
  • No longer requiring positive pressure ventilation
Indications for progressing with weaing:

At each stage in the weaning process the cuff deflation criteria should be met prior to commencing the next step in the process of  weaning the patient from the tracheostomy tube.

The process of weaning involves manipulation of the tracheostomy tube which may  increase the patient workload of breathing.  The patient should be closely observed for early signs of clinical deterioration to ensure patient safety and prevent distress.  The change in airflow from breathing via the tracheostomy tube to utilising the upper airway can be distressing for the patients.

When the decision to wean a patient from their tracheostomy tube has been reached, the process of weaning commences with cuff deflation.

Cuff Deflation

Use of Decannulation Devices

Nutrition and the Tracheostomy Patient

Bedside evaluation of Swallowing, Eating and Drinking

Communictation

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