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Long Term Ventilation

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Megan Brashear, VTS (ECC), talks about the in-depth nursing care required for veterinary patients on long-term ventilation in the ICU including recumbent patient care, oral care, and endotracheal tube care.

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Megan Brashear's picture
Megan Brashear

CVT VTS(ECC)

Enrolled: 07/2011

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Comments

Stephanie Cowan 's picture

What is the red rubber tube in his right nostril for? It didn't appear to have a cap on the end of it and looked pretty long so I'm guessing not NG tube.........

Jessica Waters-Miller's picture

Hi Stephanie, My gut tells me that the red rubber is a nasal cannula that was placed prior to the patient being put on the ventilator. I would look in the chart but the patient information isn't accessible at the moment. After discussing it with one of our doctors, she agrees on it being a nasal cannula. We would usually place a yellow feeding tube that has built in caps for an NG or NE tube.
This did lead to a discussion and I thought I would include it; if it is a nasal cannula it is okay that it isn't capped. If by chance it is an NE (nasoesophageal) tube you are right, it should be capped but it also isn't harmful to the patient to not have it capped since the esophagus is flaccid and would close down against itself. But like you said and we both agree, it is very long so I doubt it is long enough to be an NE tube. Hope that helps, really great question!

Stephanie Cowan 's picture

Thank you so much for your reply. It makes sense that it was for oxygen prior to patient being placed on the vent. I also had no idea that it could be uncapped if it WERE an NE tube. I was always taught to cap those but it's interesting that the esophagus closes down on itself. So cool to learn that! Thanks again!

Jordan Billock's picture

I was curious if the ET tube was replaced at all during this time? As a new technician this video was very helpful, so thank you!

Jessica Waters-Miller's picture

Hi Jordan,

Thanks for the great question! Yes, we will be replacing the ET tube during the patient's time on the ventilator. We would be doing this every 12-24 hours depending on patient needs and what is tolerated. This, of course, has to be done quickly. As Megan said, these patients may need their mouth cleaned (suctioned or wiped) to help with keeping that ET as clean as possible since we will be using a sterile tube to replace each time.
And, since we are on the topic (great idea for a spin-off video) we will also be deflating the cuff every 4 hours for 5-10 minutes to help the trachea not develop pressure sores or necrosis. This is also performed as tolerated.
Please let me know if you have any more questions and happy holidays!

Jessica