can you drink alcohol with a tracheostomy

You may also be asked to stop certain medications. endobj WebTracheostomy tube can be blocked by blood clots, mucus or pressure of the airway walls. To Expect After A Tracheostomy Is Removed Some of the aspects that patients should be fully aware of following removal of tracheostomy include: There are a few things the patients need to follow for the speedy recovery and when to reach for immediate medical assistance. can you drink alcohol with a tracheostomy Adobe InDesign CC 2015 (Macintosh) Cost-Utility Analysis of Home Mechanical Ventilation in Patients with Amyotrophic Lateral Sclerosis. A tracheostomy may be temporary or permanent. After the tracheostomy procedure, you'll likely stay in the hospital for several days as your body heals. x+ | <>>>/Subtype/Form/BBox[0 0 585 783]/Matrix [1 0 0 1 0 0]/Length 47/FormType 1/Filter/FlateDecode>>stream Position the mirror so you can see the opening of your tracheostomy tube. PMC Raimonde, Anthony J. Webcan you drink alcohol with a tracheostomy incident in leyton high road today. Vansteensel MJ, Klein E, van Thiel G, Gaytant M, Simmons Z, Wolpaw JR, Vaughan TM. endstream w3TPI2T0 BC#K#=SC#\. Tracheostomy can you drink alcohol with a tracheostomy The https:// ensures that you are connecting to the 2016-08-02T13:31:11-07:00 WebAlthough administered at the time of a respiratory crisis without being discussed in advance, tracheostomy shows good acceptance and results in acceptable QoL. In many instances, these difficulties persist despite the removal of the tracheostomy tube however it gets better over time. Aspiration is a pneumonic issue wherein the individuals breathe foreign objects such as food, saliva, or some other material that induces vomit or heartburn. Before Unauthorized use of these marks is strictly prohibited. 2016-07-08T11:59:57-05:00 2006 Jun;7(2):86-95. doi: 10.1080/14660820500515021. Sixty patients were studied retrospectively. Advertisement Do not stop taking pain killers unless or until advised by your doctor because they are aimed to avoid infections and relieve soreness. Bethesda, MD 20894, Web Policies WebA tracheostomy is a surgical procedure in which your surgeon creates a hole through your neck and into your trachea (windpipe). A Nation-Wide, Multi-Center Study on the Quality of Life of ALS Patients in Germany. Tracheostomy 4 0 obj Please enable it to take advantage of the complete set of features! official website and that any information you provide is encrypted Fluids help keep your mucus thin and prevent mucus buildup. ,.. www.medscape.com/answers/865068-32841/when-should-the-tracheostomy-tube-be-removed, https://www.myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zy1382, www.nursingtimes.net/clinical-archive/respiratory-clinical-archive/tracheostomy-2-managing-the-weaning-of-a-temporary-tracheostomy. Plan for your hospital stay. endstream Accessibility WebA tracheostomy is a surgical procedure in which your surgeon creates a hole through your neck and into your trachea (windpipe). endstream Tracheostomy 3 0 obj To Expect After A Tracheostomy Is Removed As you get used to the tube, you may be able to go back to drinking thinner liquids, such as water. endobj Rx-Regular Get To Know What Possibly Could Be Causing Your Symptoms! If you'll be receiving general anesthesia, your doctor may ask that you avoid eating and drinking for several hours before your procedure. A tracheostomy, or trach, may be needed if you have a blockage in your airway or severe lung disease, or for other reasons. mick mars house nashville tn; list of manchester boxers; tom hardy ufc record; Our articles are resourced from reputable online pages. for Your Tracheostomy Turn on the suction machine. Major Complication In Tracheostomy & Can You Talk After A Tracheostomy Is Removed? Clean your hands well with soap and water or an alcohol-based hand sanitizer. Corbel-Italic application/pdf Corbel-Bold Manage Settings endobj 2023 Mar;270(3):1323-1336. doi: 10.1007/s00415-022-11464-6. Adobe PDF Library 15.0; modified using iText 4.2.0 by 1T3XT and transmitted securely. Tracheostomy. StatPearls [Internet]., U.S. National Library of Medicine, 30 Nov. 2020. Rabkin JG, Albert SM, Tider T, Del Bene ML, O'Sullivan I, Rowland LP, Mitsumoto H. Amyotroph Lateral Scler. <>stream ,.. Tracheostomy WebAlthough administered at the time of a respiratory crisis without being discussed in advance, tracheostomy shows good acceptance and results in acceptable QoL. This article does not provide medical advice. Speech therapists and nutritionists can often help this process. The goal is to deliver oxygen to your lungs easily and safely. endstream 2021 Feb 1;9(2):142. doi: 10.3390/healthcare9020142. Tracheostomy (trach) care is done to keep your trach tube clean. <>>>/Subtype/Form/BBox[0 0 585 783]/Matrix [1 0 0 1 0 0]/Length 47/FormType 1/Filter/FlateDecode>>stream Unable to load your collection due to an error, Unable to load your delegates due to an error. Most people with a trach tube can lead a normal routine with eating normally however you may experience some difference when you swallow food. xs The survival rate was 65% by 1 year and 45% by 2 years after tracheostomy. Speech therapists and nutritionists can often help this process. One patient (1.6%) was liberated from MV. A tracheostomy may be temporary or permanent. WebIf you or a loved one need help with quitting drugs or alcohol, consider Asana Recovery. Careers. In many instances, these difficulties persist despite the removal of the tracheostomy tube however it gets better over time. Frequently, such patients require intubation and mechanical ventilation (MV) and, in a large proportion, receive tracheostomy, as a consequence of weaning failure. Patients with ALS have a high chance of long-term survival after tracheostomy for ARF. A tracheostomy may be performed as planned or emergency depending on the requirement. proof:pdf A tracheostomy is performed to provide airway to patients who are on a mechanical ventilator or have trouble swallowing or suffering from chronic lung disorders (aspiration). Clipboard, Search History, and several other advanced features are temporarily unavailable. 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Tracheostomy mechanical ventilation in patients with amyotrophic lateral sclerosis: clinical features and survival analysis. Percutaneous tracheostomy is minimally invasive but comes with a greater risk of airway damage. 7 0 obj for Your Tracheostomy can you drink alcohol with a tracheostomy In general, people with a tracheostomy often have problems with their routine lifestyle such as speaking, coughing, eating, drinking, and swallowing. 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Living with a tracheostomy can take some time to adapt to, but you can still enjoy a good quality of life. This article may contains scientific references. We offer medical detox, along with both residential and outpatient programs, and youll be supervised by a highly trained staff of medical professionals, counselors, and therapists. Call us any time at (949) 438-4504 to get started. This can take weeks to months to learn. Results: Some prescription pain medications can make you drowsy (very sleepy). Amyotroph Lateral Scler Other Motor Neuron Disord. Connect the suction catheter to the suction machines plastic tubing. See ASHAs information for professionals on the Practice Portals Tracheostomy and Ventilator Dependence page. Hopkins Medicine xmp.iid:ba618122-edde-4fbd-9d4c-d39225cb12ec Some of our partners may process your data as a part of their legitimate business interest without asking for consent. Most people with a trach tube can lead a normal routine with eating normally however you may experience some difference when you swallow food. You might need a tracheostomy if you have an obstructed upper airway or an underlying health condition. Survival and quality of life after tracheostomy for acute respiratory failure in <>stream We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Conclusions: 3 9 0 obj xmp.did:478c6c31-b1b6-437d-bd41-ac68b43cf268 you Webcoordination of breathing to eat with a trach in place. 14 0 obj Many of these early complications can be avoided or dealt with appropriately with our experienced surgeons in a hospital setting. 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 However, the wound will take 1-2 weeks to heal completely but during this period if the injury becomes wet or starts to develop an infection, check with the nurse or GP immediately. endstream Respiratory systems abnormalities and clinical milestones for patients with amyotrophic lateral sclerosis with emphasis upon survival. The nose, mouth, throat, and larynx form the upper airway whereas the windpipes, air tubes, and air sacs consist of the lower airway. 2003 Sep;4(3):191-206. endobj Tracheostomy Medical Videos Privacy Policy, Images and Text Policy Editorial Policy, Information Policy Advertising Policy, Financial Disclosure Policy Cookie Policy, About Us Contact Us. can you drink alcohol with a tracheostomy Swallowing can be more difficult with a tracheal tube in place but once your medical team feels you are up to it you can begin eating and drinking. This means the air going into your lungs will be dryer and cooler. WebHaving a stoma ( tracheostomy) means that the air you breathe will no longer pass through your nose or mouth, which normally help moisten, warm, and filter the air (removing dust and other particles). At first, you may be advised to drink thicker fluids, such as soups and nonalcoholic blended drinks. Trach care includes suctioning and cleaning parts of the tube and your skin. 1,2. The mean (SD) cumulative score on the LSI-11 was 9.3 (3.6; range, 0-22; higher values indicating better QoL), similar to that obtained from a control group consisting of individuals with ALS who had not received tracheostomy (9.3 4.3) and to that reported for persons in the general population. after tracheostomy for acute respiratory Tracheostomy Maintenance Most of the time a tracheostomy is only needed for a very short period of time but sometimes you may be discharged from the hospital with a tracheostomy. with a Tracheostomy * Tracheostomy Intervention and measurements: Your healthcare provider will show you how to care for your trach tube, and what to do in an emergency. Your healthcare provider will suggest fluid intake for tracheostomy tube patients because this will loosen secretions and makes coughing easier. Turn on the suction machine. You can use a mirror that hangs on a wall or stands on a surface. Drink plenty of fluids. 2007 Feb;8(1):36-41. doi: 10.1080/17482960600863951. Would you like email updates of new search results? WebTips for eating with a trach tube. 2016-07-08T11:59:57-05:00 default This site needs JavaScript to work properly. The .gov means its official. Tracheostomy Your healthcare provider will show you how to care for your trach tube, and what to do in an emergency. Careful cleaning of the trach and stoma can help Tracheostomy tubes feeding, eating and drinking converted This information is often useful for patients who have had the tracheostomy tube removed.1,2. If you'll be receiving general anesthesia, your doctor may ask that you avoid eating and drinking for several hours before your procedure. Tracheostomy Care Contributor, NT. 2010 Jul;11(4):529-30. doi: 10.1097/PCC.0b013e3181d9c70b. (a) A retrospective chart review was used and (b) prospective administration of the 11-item short-form Life Satisfaction Index (LSI-11) and Beck Depression Inventory (BDI) questionnaires to survivors, at least 1 month after discharge from hospital, was performed. An official website of the United States government. eCollection 2021. The study was conducted in an adult, respiratory intensive care unit in a university hospital. xS**T0T0 BC#0JU4RpW!i endobj As you get used to the tube, you may be able to go back to drinking thinner liquids, such as water. after tracheostomy for acute respiratory MinionPro-Regular Federal government websites often end in .gov or .mil. Like the branches of the tree, the windpipes (trachea) are further divided into smaller tubes that help to breathe and to clear the airway. Blockages can be prevented by suctioning, humidifying the air, and selecting the appropriate tracheostomy tube. Communication About End of Life for Patients Living With Amyotrophic Lateral Sclerosis: A Scoping Review of the Empirical Evidence. You might need a tracheostomy if you have an obstructed upper airway or an underlying health condition. Towards clinical application of implantable brain-computer interfaces for people with late-stage ALS: medical and ethical considerations. Corbel WebWe recommend changing the tracheostomy tube once a week to remove the dried or old secretions and maintain adequate hygiene of the tracheostomy tube and airway. xS**T0T0 BC#0JU4PpW!i Trach care includes suctioning and cleaning parts of the tube and your skin. Design: An example of data being processed may be a unique identifier stored in a cookie. w3TPI2T0 BC#K#=SC#\. xs All 13 survivors completed the LSI-11 and BDI. This article on Epainassist.com has been reviewed by a medical professional, as well as checked for facts, to assure the readers the best possible accuracy. Tracheostomy WebObvious signs of food/fluid in secretions suctioned out of the tracheostomy tube Frequent respiratory (chest) infections Crying, back arching, and batting/throwing food Choking or coughing while eating or drinking Vomiting with meals Congested lung sounds Large amount of watery secretions from the tracheostomy tube 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