Suction machine: this machine is needed to suction the secretion that gets into the tracheostomy tube (or trach) if someone cannot cough it up. If we don’t suction the secretion out of the trach, the air cannot get it, and it leads to suffocation. And what is this secretion? As you read this, I am sure you have some saliva in your mouth, right? Well, you swallow this saliva several times a day, and then it’s reproduced. A child swallows approximately 27 ounces of saliva a day. The trach keeps this secretion from getting to the mouth from the pharynx. It comes out through the tube, and this is why it’s necessary to suction there, or even better to cough it out, so one can breathe again.
There are many types of suction machines. The most important thing is that no matter where we go, we have to have two of them at hand, in case one breaks down, we will have a backup. Currently we have five suction machines: one that uses 220V, two that use batteries, one that is operated by hand and one by foot, in case there is a power outage. I remember once we spent two nights on our neighbor’s couch, because there was a power outage at our house, and we didn’t want to wait and see if the battery-operated suction machines dies
Oxygen tank and Pulse Oximeter: We have been to a lot of hospitals since Vince’s birth when Vince catches a cold. At times like these, due to his muscle weakness, he cannot breathe enough oxygen in, and he grows weak. After five years of hospital visits it became clear that even though his oxygen levels are good, when he gets sick he needs extra oxygen at home. We attach a reducer to the oxygen tank (this way the oxygen gets mixed with a little bit of sterile water), and we attach it to the tracheostomy tube. For these times we use a tweezer-like little equipment that functions in our lives almost like a key ring, we use it so often. It is called Pulse Oximeter. With this we can measure on his toes if there is enough oxygen getting into his lungs.
Ambu bag: If, for any reason, breathing difficulty occurs, after suctioning the tracheostomy tube I attach the ambu bag to the end of tube, and I apply rhythmic pressure to it, this way giving extra air. This can be used indefinitely in a case of emergency. What makes the task more difficult is when Vince becomes sick. This time a lot of secretion comes from the trach, and due to the frequency of the suctioning, it is impossible to get enough air pumped into his lungs. The air pumped in pushes the secretion back into the lungs that is just about ready to leave.
Inhaler: This is a machine that vaporizes salty water that can be breathed in after we place it on the tracheostomy tube. This is like walking on a beach in a strong wind. Imagine the kind of wind that makes your lips salty. We use this because it doesn’t allow the secretion coming from the trach get dried up, and it is easier to suction out the thicker bits after its use.
Cough machine: this helps the secretion come out easier and not stagnate in the lungs. It works like a vacuum cleaner, but doesn’t only suction, it blows inwards as well. It elicits such stimulus that irritates the diaphragm and prompts one to cough if there is secretion in the lungs. If there isn’t any or there is only a little bit of secretion, this machine is still useful, because it circulates the lungs and stirs up even that little bit of secretion, so it won’t settle.
CPAP Breathing Machine: Thankfully Vince’s oxygen levels are very good when he doesn’t have a cold. However, at nights we have to circulate his lungs with a so-called CPAP machine. This helps his lungs open up more than what he could achieve on his own, and this way the oxygen from the air he breathes in gets utilized better. People who snore at night use a similar machine to bridge any potential respiratory failure. We have never needed a classic breathing machine at home, only in the hospital during surgery. So I don’t have any experiences to share, but you can find a lot of practical advice at the Moms of Trach Babies closed Facebook group.
Other machines: You need a lot of creative ideas when you find yourself in a situation you don’t have a precedent for in your surroundings. We can use our abdominal belt purchased in a TV shop very well when Vince has a cold (both my husband and I have a little belly, but we have never used this equipment according to its true purpose J). We place it on his chest or back, and we turn it on. The cilia (tiny hair-like structure) on his lungs start vibrating, the secretion detaches, and it is easier to suction it afterwards. With this procedure we have a ritual as well, where I lay Vince on my legs upside down while the vibration is happening, so when the secretion detaches, it can start heading upwards right away, in the direction of the larynx.
Also, we have a machine with which we can help train Vince’s intensity of inhalation. This is a sort of machine where as he sucks the end of the tube, the little balls in the device start jumping. The harder he sucks, the bigger the movement of the intercostal muscles (the muscles between the ribs), and so is its training. Of course, we attach this machine to his tracheostomy tube, not to his mouth.
You can read about the hygienic devices related to the tracheostomy tube more in detail under Cleansing and Replacement.