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The process whereby a tracheostomy tube is removed once patient no longer needs it.
When the initial indication for a tracheostomy no longer exists.
A patient is considered a candidate for decannulation once the following conditions are met.
Criteria for decannulation
Once all of the above criteria are met, the patient is informed that their trach tube is going to be removed. They are instructed that they may experience a sensation of shortness of breath for a few minutes once they are decannulated.
Arrangements should be made for back-up personnel (RT or RN) to be available in case of emergency. Decannulation is usually not done at home.
The patient is placed supine (flat) on their bed, the tube is removed and the opening into the neck is covered with sterile gauze and a tape is placed over the gauze.
The patient is instructed to occlude the gauze with their finger tip every time they cough or speak so that air does not leak. They should change the gauze and the tape at least once a day (more often as needed) until the hole in the neck heals itself closed over the next few days to weeks. In a minority of patients (<10 %), the opening into the neck skin has to be surgically closed.
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