Indications for tracheotomy tube blockage include recovery of consciousness, ability to cough up sputum on one’s own, recovery of swallowing reflex, and airway patency.
1. Recovery of consciousness: If consciousness is recovered and the patient is able to open his eyes and turn his eyes according to instructions, tracheotomy can be considered.
2. Ability to cough up sputum: If the patient is unable to cough up sputum voluntarily, extubation will cause airway obstruction again. Therefore, tracheal intubation should be considered only when the patient’s ability to cough up sputum is restored.
3. Recovery of swallowing reflex: If the swallowing ability has not been recovered, it is easy to cause reflux aspiration, resulting in aspiration pneumonia or aspiration atelectasis, which will aggravate the lung infection. Therefore, in order to avoid reflux aspiration, tracheal tube sealing should be considered when the swallowing reflex recovers.
4. Evaluation of lung and airway patency: If there is a granulation in the airway, this granulation will continue to block the airway after the trocar is removed, causing symptoms of dyspnea. Lung and airway patency should be carefully assessed during tracheal intubation.
Before performing tracheal intubation, the tracheal tube should be replaced with one of slightly smaller diameter, and then the mouth of the tracheal tube should be plugged with a soft plug, and the patient’s respiratory changes should be closely observed. After 24 hours of observation to confirm the absence of respiratory distress, the tracheal cannula can be removed and the tracheal tube can be sealed.