The advisability of regular tube changes is well established in tracheotomy after-care. When the operation has been performed for respiratory obstruction, and the replacement tube proves difficult to reinsert, the changing of a tracheotomy tube carries with it a definite hazard. The following method is presented as an attempt to eliminate this hazard by providing not only a continuously patent airway throughout the procedure but also a guide for the insertion of the replacement tube.
A length of tubing (the straight segment of a uretheral catheter is often quite satisfactory) of a uniform outside diameter and an inch or two longer than twice the length of the tracheotomy tube is selected. Its outer diameter is approximately the same as the outside diameter of the inner cannula for the replacement tracheotomy tube (when lubricated it should pass readily, but not loosely, through the outer cannula of the replacement). This guide
TUCKER GF. A HOLLOW GUIDE TO AID IN THE CHANGING OF TRACHEOTOMY TUBES. AMA Arch Otolaryngol. 1956;64(1):66–67. doi:10.1001/archotol.1956.03830130068011
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