In nursing homes, residents who have trouble breathing on their own (from illness or weakness) might require a breathing tube. A breathing tube, or endotracheal tubes can be used for multiple situations where a patient needs assistance breathing, most nursing home patients who require a breathing tube also require the use of a ventilator. In these patients, a breathing tube and ventilator allows staff to remove mucus from the patient’s lungs and keeps the person alive.
A breathing tube is a plastic tube that is used during artificial respiration to provide a patient with oxygen. The tube, which is attached to a breathing machine (ventilator) or breathing bag (manual resuscitator), is placed into the trachea (windpipe) through the mouth or nose and is held in place by tape or soft straps. A breathing tube is usually used only for short periods of time; if a patient requires a breathing tube for more than a couple days, the doctor might recommend a tracheostomy tube (see below).
A patient with a endotracheal tube, is usually unable to speak because the tube passes directly through the vocal cords. This can be very frustrating for residents because it is harder for them to communicate with nursing home staff. In addition, a patient on a breathing tube cannot eat or drink because it could cause choking. Instead, the patient has to receive fluid and nutrition through an intravenous (IV) tube or feeding tube. This makes the patient much more dependent on nursing home staff for everyday activities.
The nursing home staff must take precautions to ensure that the endotracheal tube does not become clogged. The tube must be suctioned from time to time to remove mucus from the patient’s lungs. Other complications can occur, including the breathing tube actually becoming displaced and requiring reinsertion. To prevent the patient from removing the tube, a patient’s hands are often restrained and a mild sedative might be used.
A tracheostomy tube can also be placed into a patient’s throat to help a resident breathe. With a tracheotomy, a surgeon creates a hole in the front of the neck that goes into the trachea. A tracheostomy might be required because of an emergency situation where the airway is suddenly blocked or impaired, the resident suffered an injury to the face or neck, or when a resident requires a ventilator for long-term breathing assistance.
Most tracheotomy procedures are planned procedures performed in a hospital setting, which reduces the risk for complications. The benefits of using a tracheostomy is that the patient can still talk and it is often more comfortable than an endotracheal tube that is inserted in the mouth and down the throat.
Many nursing home patients require either breathing tubes or tracheostomy tubes due to difficulty breathing and can be a short-term or a long-term solution for a resident. The nursing home staff must be properly trained to ensure that the tubes remain clean and free of mucus. Serious complications can occur if the staff allows the residents to become agitated and displace their breathing tubes or if the facility fails to provide regular maintenance to assure a clear airway.
If your family member is a victim of complications involving breathing tubes, I would honor the opportunity to discuss your situation. As always, our legal services are completely free if there is no recovery for you. Speak to our experienced nursing home lawyers today. (800) 926-7565.
Endotracheal Tube (http://www.suru.com/endo1.htm)
Mayo Clinic – Tracheostomy (http://www.mayoclinic.com/health/tracheostomy/MY00261)
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