21-0141 Tracheostomy Decannulation Monitor System

Alert caregivers in the event of a partial or complete dislodgement of the tracheostomy tube.Use of an electrical circuit in the system accounts for anatomical differences and small movements, such as breathing, without resulting in false positives. Ca…
  • Alert caregivers in the event of a partial or complete dislodgement of the tracheostomy tube.
  • Use of an electrical circuit in the system accounts for anatomical differences and small movements, such as breathing, without resulting in false positives.
  • Can be incorporated into existing tracheostomy tube systems.

Abstract:

Background
Accidental tracheostomy dislodgement (decannulation) is one of the leading causes of death in pediatric tracheostomy patients in the outpatient setting. Accidental, unsupervised decannulation can also have dire consequences in inpatient settings. For example, decannulations can occur in children when the ties holding the tracheostomy tube in place are too loose, combined with an event such as the patient coughing or pulling on the tracheostomy tube. Since many pediatric patients with tracheostomy tubes are non-verbal (due to either age or incapacitation), a decannulation event can occur unnoticed in an unsupervised patient. Tracheostomy tubes stent the tracheal stoma and if a tracheostomy tube becomes dislodged, the stoma can narrow quite quickly, sometimes critically compromising airway safety. By detecting decannulation events early, caregivers can reinsert the tracheostomy tube in most cases, thus averting disaster. While there are relatively few monitoring systems available for adults, there are virtually no commercially available monitoring systems for pediatric patients. Given the potentially life-threatening consequences associated with decannulation of a tracheostomy tube in pediatric patients, a monitoring system to alert caregivers is urgently needed. Alerting a caregiver to a full or partial decannulation would allow a rapid response to the patient, attempt reinsertion of the tracheostomy tube, thereby securing the airway. Rapid intervention would help prevent the severe complications of decannulation, such as anoxic brain injury and even death.

Technology Overview
Researchers in the Departments of Pediatric Otolaryngology and The North Carolina Translational and Clinical Sciences Institute have developed a tracheostomy decannulation monitor system to alert caregivers in the event of partial or complete dislodgements of the tracheostomy tube. The monitor system can be attached to existing tracheostomy tube systems through contact sensors that are attached to the tube flanges, which also have tie holes for securing the system to the patient. An electrical circuit is formed between the contact sensor and the dressing (e.g. Mepilex) that covers the stoma of the patient, which contains conductive material (copper wire/foil/etc.) in or on the surface. When the tracheostomy tube is partially or fully dislodged, the electrical circuit is disrupted, resulting in the alarm being triggered. Several electrical contacts between the sensor and dressing can be utilized to detect a partial separation of the tracheostomy tube. The design of the system allows for the ability to accommodate varying anatomy and small movements (such as breathing, etc.) without resulting in false positives, and is low profile to allow the tracheostomy tube system to sit flush against the patient’s neck. A working prototype of the tracheostomy decannulation monitor system has been developed (figures below), which demonstrates the feasibility of this approach for alerting caregivers.

Website:

https://unc.flintbox.com/technologies/1085A2A07245457F86DDC380BDB4EC5E

Advantages:

  • Alert caregivers in the event of a partial or complete dislodgement of the tracheostomy tube.
  • Use of an electrical circuit in the system accounts for anatomical differences and small movements, such as breathing, without resulting in false positives.
  • Multiple electrical contacts between the sensor and dressing can be utilized to detect a partial separation.
  • Can be incorporated into existing tracheostomy tube systems.

Potential Applications:

The tracheostomy decannulation monitor system can be used for pediatric patients in clinical settings as well as in-home care settings. In addition to pediatric patients, the system can be used for monitoring adult patients with reduced capacity that are at risk for accidental decannulation of their tracheostomy tube.

Contact Information:

Name: Matthew Howe

Title :

Department :

Email: matthew.howe@unc.edu

Phone: 919.966.3929

Address :