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Advanced Applications of Home-Based Primary Care - ...
Tracheostomy Tube Replacement Procedure
Tracheostomy Tube Replacement Procedure
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Pdf Summary
The document, created by the Home Centered Care Institute in 2021, provides comprehensive, step-by-step instructions for Home-Based Primary Care (HBPC) providers on how to replace a tracheostomy tube in a home setting. Key steps include ensuring a clean working surface, gathering necessary equipment, positioning the patient correctly, and maintaining a sterile environment.<br /><br />* **Preparation and Equipment:** <br /> - Essential items include gloves, a suction machine, a clean tracheostomy tube kit, a smaller backup tube, a manual resuscitation bag, and other medical and protective supplies.<br /> - Position the patient supine or semi-recumbent, ensure good lighting, and have everything laid out on a sterile field.<br /><br />* **Procedure:**<br /> 1. Wash hands and don protective gear (mask, eye protection, gloves).<br /> 2. Suction the patient if necessary.<br /> 3. Check the new tracheostomy tube for defects and test the cuff for leakage.<br /> 4. Lubricate the new tube and insert the obturator.<br /> 5. Remove the old tracheostomy tube after deflating the cuff and detaching any connected devices.<br /> 6. Clean the stoma and ensure it is clear of debris before inserting the new tube using a curved motion.<br /> 7. Secure the new tube with tracheostomy ties and check the patient's respiratory status post-procedure.<br /><br />* **Post-procedure:** <br /> - Document details of the procedure.<br /> - Order replacements for any used equipment.<br /><br />* **Considerations:**<br /> - The initial change of a tracheostomy tube (3-7 days post initial procedure) should be performed in a controlled environment due to higher risk of complications.<br /> - No consensus on the frequency of tube changes exists, but a change every three months is recommended to prevent biofilm formation.<br /><br />* **Billing:**<br /> - Routine tracheostomy tube changes are generally considered part of the E/M service and are not separately billable.<br /> - CPT code 31502 is only applicable for tube changes "prior to the establishment of a fistula tract," thus may not be suitable for home settings.<br /><br />For further assistance, HBPC providers can reach out to the HCCIntelligence Resource Center for webinars, virtual office hours, and additional resources.
Keywords
Home-Based Primary Care
tracheostomy tube replacement
sterile environment
medical equipment
patient positioning
procedure steps
post-procedure documentation
tracheostomy tube change frequency
billing and CPT codes
HCCIntelligence Resource Center
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