Tan Tock Seng Hospital HVRSS – Home Ventilation and Respiratory Support Service Tracheostomy Tube Care at Home
Part 2 : Oxygen Concentrator and Humidifier Supplemental oxygen can be given when patient feels breathless or SpO2 is low. Switch on the oxygen concentrator. Adjust the flow by turning the knob. While using the ventilator connect the oxygen tube from the concentrator to the oxygen port of the ventilator as shown. The port can usually be found at the side or the back of the machine. Alternatively the oxygen adaptor can be used in the ventilator circuit. Connect the oxygen tube to the connector and join it in the circuit. When not using the ventilator Connect the oxygen tube to the adaptor and trach mask. Apply the mask by covering the tube and secure it by tightening the strap around the patient’s neck. Extra humidifier chamber can be attached to the oxygen concentrator when using the trach mask. It cannot be used together with the ventilator as the moisture in the air will damage the machine. Oxygen can also be delivered with the speaking valve. Connect the oxygen tube to the side port of the speaking valve. You may need to cut the oxygen tube as the side port of the speaking valve is small. With tracheostomy, the upper airway is bypassed during ventilation. Hence, the humidifier is important in preventing heat and moisture loss. It is also recommended to improve patient’s comfort. When using the ventilator there are 2 ways to warm and humidify the air delivered. Heated humidifier is a device that makes the inhaled air warm and moist by actively heating the air and it prevents secretion from thickening. Connect the fused water-trap tube from the outlet port to the patient. Connect the short breathing tube from the ventilator to the inlet port of the humidifier. When refilling, join the two tubes for ventilation. Fill up the humidifier chamber with sterile water until the marking. Avoid overfilling, as the water might overflow and cause obstruction or damage to the machine. Temperature can be adjusted according to the thickness of secretion. There should be visible tiny drops collected on the inner surface of the tube. Place the water trap cup at the lowest point in the circuit so that water will drain into it. Do not drain the water back to the humidfier. You should empty the cup before transferring the patient or if water collection reaches 1/3 of the cup. Rinse the chamber daily. You may also use HME or Heat and Moisture Exchanger for humidification. HME traps the heat and moisture from the out breath air in the tube so that the inhaled air will bring the heat and moisture back to the patient. Insert the HME in the circuit between the exhalation port and the trach adaptor. Change the HME when it is stained with secretion or becomes wet. Otherwise, change it every 2 days. Important. Ensure the connection sequence is in this order. Exhalation port HME trach adaptor and to the patient. Do not use heated humidifier and HME together as excessive water in HME can cause blockage. Thank you for watching. For more information, contact HVRSS or speak to your doctor today.