Management of tracheotomized patients being cared for at home

FUJISAWA Tsutomu, HIRABAYASHI Hideki, TANAKA Toshiaki, SHOUNO Noboru, BABA Koutarou

doi:10.11334/jibi1954.47.2_126

Many patients who are being cared for at home have some degree of impairment in the areas of medicine in which doctors in the fields of otorhinolaryngology and bronchoesophagology specialize, including aoudition, olfaction, gustation, mastication, swallowing, voice, speech and respiration. The time has come for us to actively participate in the management of home care patients. At the present, we have 19 adult and 26 pediatric tracheotomized patients who are being cared for at home. The average duration of home care for the adults is 2 years and 6 months, whereas that for the children is longer at 3 years and 4 months. The onset of complications, observed by airway technologists, is high at 73.7% for the 19 adults and 96% for the 26 children. Hence, it would be desirable for medical personnel to take an active role in providing medical care to these patients, including educating family members about airway management. The formation of granulation tissue around the tracheal stoma is one of the complications associated with tracheotomy. When tracheotomized patients are being cared for at home, granulation must be addressed before it makes decannulation too difficult. Thus, the clinical course of these patients needs to be followed periodically. An appropriate cannula must be selected depending on such information as the severity of swallowing impairment, respiration, etiologic disease, and age, thus caregivers need to understand the characteristics of each type of cannula.

Management of tracheotomized patients being cared for at home

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