It’s easy to take respiratory wellness for granted. Breathing is, after all, controlled by the autonomic nervous system, meaning it requires no thought or effort. When a life-altering injury or serious illness affects a loved one’s ability to breathe, however, caregivers are forced to put a tremendous amount of thought into respiratory processes. To ensure long-term success and wellbeing at home – for both caregivers and patients – proper respiratory care training and an adequate support system are essential.
Here, we offer three of our top tips for caregivers of patients with tracheostomy or ventilator needs. But first, let’s dive into the basics of respiratory care.
What is a ventilator?
A ventilator, also known as a mechanical ventilator or respirator, is a medical device that provides artificial respiration by moving breathable air into and out of the lungs. This helps a patient who is unable to breathe adequately on their own. Ventilators are used in a variety of medical situations, including during surgery, in intensive care units, and for long-term home care for individuals with chronic respiratory conditions.
After sustaining a traumatic brain injury, for example, patients may require mechanical ventilation due to poor mental status, inability to protect the airway, loss of brainstem reflexes, and intracranial pressure election. In fact, acute respiratory distress syndrome (ARDS) is the most common extra-cranial complication among brain injury patients, affecting 35% of the neurocritical care population.1
While ventilators can be life-saving in critical medical situations, prolonged dependence can have adverse effects on outcomes. Extended ventilator dependence (defined in one study as longer than 21 days) has been associated with increased mortality and longer hospital stays. It also increases the risk of complications such as muscle weakness, pressure ulcers, sepsis, candidemia, pulmonary embolism, and hyperactive delirium.2
To help patients wean off of mechanical ventilation, a tracheostomy may be performed.
What is a tracheostomy?
A tracheostomy is a medical procedure that involves creating an opening in the neck to insert a tube into the windpipe, or trachea. This tube allows air to enter the lungs, bypassing the mouth, nose, and throat. The procedure can be temporary or permanent and is typically performed when there is an obstruction to breathing, such as from swelling, tumors, or severe injuries, or when long-term mechanical ventilation is needed.
Tracheostomies are often necessary to improve comfort and mobility, reduce the use of sedatives, decrease exposure to secondary insults, and enable early rehabilitation. Durations of tracheostomy use vary greatly. For some, it may only be needed for a few days, while for others, the tracheostomy may be a permanent necessity.
Preparing for short- or long-term at-home respiratory care can feel daunting. While caring for a loved one with ventilator or tracheostomy needs can be challenging, it is more than possible with the right training and caregiver support.
Here are three of our top tips for caregivers providing respiratory care.
1. Find the right training
Tracheostomy and ventilator maintenance require technical knowledge and a practical skillset that take time to perfect. It’s essential to receive training from qualified medical professionals who can guide caregivers through the process of learning, observation, and practice. At Nexus, we provide an average of 60 training hours to prepare families for at-home care.
2. Follow best practices
Once caregivers have mastered the basics of respiratory care, it’s important to remain diligent and prepared for unexpected circumstances. We recommend that caregivers attend basic life support training (BLS) and obtain a BLS card should the need for emergency care arise. Following basic best practices — such as keeping a trach go-bag packed, choosing non-restrictive clothing, and avoiding activities that submerge the patient in water — can also be life-saving.
3. Maintain personal health
Caring for a loved one with respiratory care needs can be overwhelming — and exhausting. Maintaining physical and emotional health by getting adequate sleep, making time for leisure activities, and nurturing relationships with friends and other family members can help to prevent burnout.
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