HINT: What is new and different with tracheostomy tubes?
Connected Care Quick Hits are up to date and evidence based recommendations for the care of children with medical complexity & technology dependence, from hospital to home.
HINT: What is new and different with tracheostomy tubes?
SITUATION:
This Quick Hit was developed following the discontinuation of select tracheostomy products commonly used in paediatric home and community care, and the introduction of new, replacement products.
BACKGROUND:
Many children and youth with artificial airways in home and community care use Shiley tracheostomy tubes.
The manufacturer is in the process of discontinuing current Shiley neonatal, paediatric and adult tracheostomy tubes and replacing them with a new line of Shiley Flex tracheostomy tubes.
ASSESSMENT:
Complete a safety checklist at the start of each shift when caring for children with artificial airways. This includes confirming the brand, type and size of the child's tracheostomy tube.
The new line of Shiley Flex tracheostomy tubes includes an updated naming system and several updated features.
The following chart outlines the updated Shiley neonatal and paediatric tracheostomy tube classification system.
The new Shiley Flex adult tracheostomy tubes, sometimes used in paediatrics, will also have an updated naming system. They will now be categorized based on 4 criteria. See below for an example.
WHAT ARE THE DIFFERENCES WITH NEW TUBES?
Shiley Flex tracheostomy tubes will now all have a clear flange for increased visibility of the skin.
Cuffed tubes have a new cuff shape (Taper Guard) for reduced removal force and improved air leak.
Adult tracheostomy tubes have an integrated connector, allowing for ventilation with or without the inner cannula.
RECOMMENDATION:
Connected Care Recommends the following actions in response to the new Shiley tracheostomy products:
Partner with the family caregiver and point of care team to understand if the child's current tracheostomy will be affected by the product discontinuation.
Replace all current and emergency tracheostomies with the new products and discard old supplies to avoid errors and confusion.
Reassess depth for tube suctioning as the new tracheostomy tube may have a slightly different length than the child's previous tube. Visit this article for information on how to measure tube suctioning depth.
Confirm the inner cannula (if applicable) is insitu during your safety check. When changing the inner cannula, replace the cannula prior to reconnecting the client to their ventilator.
Clean the new Shiley Flex tracheostomy tubes using the previous recommended cleaning method for plastic tracheostomy tubes.
Reference the following resources for more information about ShileyFlex Tracheostomy tubes
Shiley Neonatal and Pediatric Tracheostomy Product Information
Connected Care Live is not to be used in the event of an emergency.
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