Author(s)
Priya Krishna
Affiliation(s)
Loma Linda University
Abstract:
The balloon that wouldn’t pop: a cautionary tale about tracheostomy tube managementObjective: To describe a tracheostomy tube management complicationMethods: single retrospective case report studyResults/Report: A 26 y/o male with a history of a gunshot wound to C1abstain 2 years prior was tracheostomy tube dependent and paraplegic as a result. His presenting complaint was inability to tolerate his Passy Muir valve and difficulty eating because of a feeling of choking which induced panic which had been occurring for the last 2 months. The patient was ventilator dependent so a decision was made to do a more thorough rigid operative laryngotracheoscopy. A standard 10 cc syringe was used to deflate the cuff of his 5-0 Shiley distal XLT tracheotomy tube. However, a fully inflated balloon with 50 cc of air was withdrawn from the stoma. Also noted was impressive ulceration of the posterior tracheal wall in the shape of the balloon. Further investigation revealed poor understanding of tracheostomy cuff management by nursing and RT staff at the patient’s care facility.Conclusion: This case demonstrates the need for awareness of the strength of the tracheostomy cuff balloon and better education of long term care facility staff on cuff management in order to prevent complications.